THE UNINSURED: Patients’ Rights Bills May Slow Progress
State lawmakers' pursuit of patients' rights initiatives may run counter to another goal of many legislatures -- expanding health coverage for the uninsured, Business Insurance reports. A survey of state legislative activity recently released by the Washington-based Blue Cross & Blue Shield Association found that at least 12 states are expected to "seriously consider" legislation this year that would permit patients to sue their HMOs -- following the leads of Texas, Louisiana and Georgia. At the same time, 14 states last year passed laws to expand coverage to the uninsured, with more expected to do so this year. Some states that are working to do both have already encountered a "direct clash." In Vermont, for example, the governor has asked the legislature not to enact stronger patient protection laws, fearing that the increased threat of lawsuits will drive health care costs too high for him to meet a promise to "cover every child in the state" before leaving office.
Expanding Formularies Creates Conflict
Legislative moves to expand prescription coverage also run counter to the goal of reducing the uninsured ranks and holding down health care costs, Business Insurance notes. Although employers are encouraging the use of formulary and generic drugs to handle rising drug costs, "measures that would weaken the cost effectiveness of such an approach" -- such as requiring MCOs to cover non-formulary drugs in some circumstances -- were passed in 10 states last year. The Blue Cross survey also found that legislation requiring coverage of patient care costs during clinical trial participation passed five states last year and will be considered by another eight this year, while physicians in nine states are likely to mount "strong efforts" to pass legislation that allows collective bargaining (Hofmann, 2/21).