HCS SCS SB 567 & 792 -- Health Insurance Coverage

SPONSOR:  Dougherty (Schaaf)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 10 to 0.

This substitute changes the laws regarding health insurance
coverage.

HEALTH INSURANCE BENEFITS

Currently, an employer may provide or contract for health
insurance at a reduced premium rate for employees who do not
smoke or use tobacco products.  The substitute allows the
employer to also provide or contract for health insurance at a
reduced deductible level for employees who do not smoke or use
tobacco products.  Insurers or small-employer carriers offering
these policies will not be in violation of any unfair trade
practice.

HEALTH INSURANCE COVERAGE FOR CLINICAL TRIALS

The substitute requires health insurers to cover routine patient
care costs incurred as a result of phase II clinical trials for
cancer treatment.  Currently, coverage is only required for phase
III and IV of these trials.

HEALTH INSURANCE CO-PAYMENTS FOR PRESCRIPTION DRUGS

Health insurers will be required to charge only one co-payment on
a prescription if the required single dosage is not available and
a combination of dosage amounts must be dispensed to fill the
prescription.  This provision does not apply to prescriptions in
excess of a one-month supply.  If technology does not permit
adjudication, the health carrier or health benefit plan will
provide reimbursement forms for the patients.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of Unknown
exceeding $66,740 in FY 2007, Unknown exceeding $133,480 in
FY 2008, and Unknown exceeding $133,480 in FY 2009.  Excludes
unknown reduction in health care premium costs.  Estimated Cost
on Other State Funds of Unknown exceeding $57,060 in FY 2007,
Unknown exceeding $124,120 in FY 2008, and Unknown exceeding
$124,120 in FY 2009.  Excludes unknown reduction in health care
premium costs.

PROPONENTS:  Supporters say that the bill will allow patients to
receive treatment for a diagnosis at a earlier stage.  Clinical
trials are a vital part of providing the best possible care for
cancer patients and contribute to finding a cure for cancer.
None of the current cancer therapies would be available without
patient participation in clinical trials.

Testifying for the bill was Senator Dougherty; Maryann R.
Coletti, Siteman Cancer Center; and Missouri State Medical
Association.

OPPONENTS:  There was no opposition voiced to the committee.

OTHERS:  Others testifying on the bill say that for every 1%
increase in health insurance costs, 200,000 people drop their
coverage.  These mandates will not affect the insurance companies
but rather Missouri citizens who pay insurance premiums.  Phase I
and II trials are usually the first time these drugs are tested,
and insurance companies do not want to be a source of payment for
drugs that could potentially be very harmful.

Others testifying on the bill were Missouri Association of Health
Plans; and Golden Rule Insurance Company.

Dominic Lackey, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 2nd Regular Session
Last Updated November 29, 2006 at 9:46 am