Insurance and Real Estate Committee

JOINT FAVORABLE REPORT

Bill No.:

HB-5021

Title:

AN ACT EXPANDING HEALTH INSURANCE COVERAGE FOR OSTOMY SUPPLIES.

Vote Date:

2/19/2009

Vote Action:

Joint Favorable

PH Date:

2/3/2009

File No.:

SPONSORS OF BILL:

Insurance and Real Estate Committee

REASONS FOR BILL:

This bills mandates up to $5000/year of health insurance coverage for appliances and supplies relating to an ostomy. (Increasing it from $1000/year)

SUBSTITUTE LANGUAGE:

Changes “delivered, issued for delivery, renewed or continued in this state “

to “delivered, issued for delivery, renewed, amended, or continued in this state”.

RESPONSE FROM ADMINISTRATION/AGENCY:

Richard Blumenthal, Attorney General, supports this bill. He has been hearing about issues with insurers providing coverage for ostomy-related supplies before the 2000 legislation went into effect. These supplies are a critical, integral, necessary and ongoing part of these procedures. The $1000 coverage needs to be amended to accommodate the rapid and dramatic increases in cost for these supplies.

NATURE AND SOURCES OF SUPPORT:

Mary Fritz, State Representative, 90th District, noted that in 2000, CT was the first state to mandate health insurance coverage for ostomy-related supplies. This prevented cancer survivors, like one of her constituents, from being denied coverage because insurance companies called these supplies “cosmetic.” In 2000, $1000/year was sufficient to help patients get the equipment they needed, but now in 2009 the costs of these supplies are increasing, so likewise the annual coverage should increase.

American Cancer Society explained that ostomy procedures are performed on patients suffering from cancer of the small intestine, colon or bladder who require a surgically created means of discharging bodily waste. Commonly a “pouch system” is used to collect waste from an opening in the body. The types of equipment are very expensive and especially in economic times like these, the increase in mandated coverage will help patients manage these costs.

NATURE AND SOURCES OF OPPOSITION:

Susan Halpin, Lobbyist, CT Association of Health Plans pointed out that CT has the 5th highest number of mandates in the country. (with a total of 49 mandates, OLR Report: 2004) Each mandate increases health insurance costs. These costs affect small businesses trying to provide their employees with insurance and cause individuals to have to go without health insurance because it is too expensive.

*25% of the uninsured are priced out of the market because of state mandates.

(OLR Report: 2004)

*Mandates increased 25-fold over the period 1970-1996, an average annual growth rate of more than 15%.

(PriceWaterhouseCoopers Article: 2002)

*For every 1% increase in premiums, 300,000 people become uninsured.

(Lewin Group Letter: 1999)

Eric George, Associate Counsel, CT Business and Industry Association knows that mandates like this bill harm CT businesses' ability to afford of health insurance, especially small businesses. These types of bills will cause CT's health care system to be even more costly and inefficient.

*Health Insurance Mandates increase premiums by as much as 65%.

(Council for Affordable Health Insurance [CAHI] report: 2006)

Reported by: Sarah J. Richards

Date: 2/25/09