Legislature May Establish Commission to Consider Mandatory Coverage Bills
Assembly members this week agreed to temporarily set aside 18 bills that would require state health plans to cover additional services for members and said that they may establish a commission to consider the costs and "medical benefits" of the legislation, the Los Angeles Times reports. The bills would require state health plans to cover services such as bone marrow donor tests, ovarian cancer tests, wigs for cancer patients and improved substance abuse treatment, the Times reports. According to health plan officials, the bills would cost employers and plan members an estimated $3 billion and "exacerbate a crisis of affordability" in private and public health coverage. Walter Zelman, president of the California Association of Health Plans, said that the state has approved similar bills in the past "without any understanding of what they cost." Assembly Health Committee Chair Helen Thomson (D-Davis) said that a commission established to evaluate the 18 bills would "help find the truth and help us set our priorities." She added, "We simply can't afford to cover every possible service. On the other hand, the industry has frequently cried wolf. ... We need a better process of evaluation than we have right now." Consumer advocates said that the proposed commission should "give ample consideration to the medical benefit" of the bills, not only their costs. Anthony Wright, director of organizing for Health Access of California, said, "At the end of the day, people need to get the care that they need. We need a real process to actually look at these treatments and say in certain instances, 'Maybe this is medically necessary'" (Ornstein, Los Angeles Times, 4/26).
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