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An Illness per Bill

State Capital Bureau

February 02, 1995

JEFFERSON CITY _ In the absence of a universal health care bill in this legislative session, several lawmakers are trying to expand health-insurance coverage in another way: on a per-illness basis.

Legislators have introduced several bills requiring insurance companies to offer increased coverage for breast cancer screenings and treatments. Other bills would require insurers to cover chemotherapy, bone marrow transplants, prostate cancer screenings and colorectal screenings.

"It would be simpler to look at it all at once, to get it all in one package," said Rep. Mary Bland, D-Kansas City. Bland is the sponsor of a bill to require insurers to expand coverage of mammograms. "But if it has to be done piecemeal, so be it. Just so it gets done."

This session's bills requiring insurers to cover specific illnesses continue a trend started in past legislative sessions. Since 1992, Missouri lawmakers have introduced bills requiring insurance companies to increase coverage for mental health, infertility, AIDS-infected adopted children, and even weight-reduction counseling.

None of these bills passed, however, and many of the specific illness bills in this session are versions of bills that have failed in the past. The strongest opposition to these bills comes from the insurance industry, Bland said.

But bills requiring insurers to cover specific illnesses harm insurance buyers more than insurance companies, said Joe Briscoe, assistant general counsel for General American Life Insurance Company.

"There's no added expense to insurance companies because we'll recover it in premiums," Briscoe said. "It's just an incentive for people not to buy insurance."

Also, these bills "generally favor a pretty restrictive audience," Briscoe said.

But bills dealing with specific illnesses have the advantage of generating less opposition than larger bills that try to solve several problems at once, Bland said.

"So far, we haven't been able to pass a major piece of (health) legislation that encompasses many solutions," Bland said.~ "If this way is less threatening, maybe that's the way to do it."

Rep. Sue Shear, D-St. Louis County, has introduced a bill that would ban insurance companies from discriminating against a woman with fibrocystic condition unless there is an indication the woman is at risk for breast cancer.

"The American Cancer Society has said this doesn't have anything to do with breast cancer," Shear said. "There's no reason insurance companies should call this a pre-existing condition or refuse to cover women with it."

Shear said she agrees that a comprehensive health care plan would be preferable to piecemeal insurance coverage expansion, but said she didn't know whether either could be passed.

"The insurance companies are pretty strong, and they don't want anything at all," she said.

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