Health Care Mandates are Adding Up

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Betsy Earls
Associated Oregon Industries
Oregon largest business lobby

Health insurance mandates are thick on the ground this session, although not all of them have had hearings.  Those that have had hearings will have to move out of committee in the next few weeks; others may turn into study groups or task forces which make recommendations next session.

SB 316—Routine costs of care while participating in clinical trials:
SB 316 requires health insurance carriers to cover the costs of routine care for patients enrolled in clinical trials.  The bill does not require that insurance companies pay costs related to the clinical trial—only those costs that would be incurred and covered if the patient was not enrolled in the trial.  AOI met with health insurance carriers, OHSU and Senators Alan Bates and Richard Devlin in early February in an effort to reach agreement on specific language in the bill.  The meeting was a complete success, but due to drafting problems, correct amendments did not emerge until recently.  SB 316 had a work session last week, and passage is expected.

SB 734—Tobacco cessation treatment mandate: SB 734 requires a one time treatment mandate for tobacco cessation.  The bill does not appear to have any opposition, but coverage for state insurance programs could be quite costly.  The committee intends to decide the future of the bill once it has a fiscal impact statement in hand.

SB 864—Mandated coverage for brand-name fibromyalgia drugs:
Prevents insurance companies from requiring that patients try generic drugs before covering the cost of a brand-name drug.  The committee is waiting to hear from the Health Resources Commission before moving the bill.

SB 876—OHP to cover brand-name immunosuppressant drugs mandate: SB 876 addresses only immunosuppressant drugs used in connection with organ transplants, and is opposed by AARP, as well as the Oregon Division of Medical Assistance Programs.  DMAP testified that the bill would cost the state $357,000 in the next biennium because it would prevent the use of generics that are currently available for organ transplant treatment.  No further action on the bill was scheduled.

HB 2589—Hearing aid mandate: HB 2589 would require insurance companies to cover the cost of hearing aids for children.  A public hearing was held on April 10th, but the bill has not yet been scheduled for work session.

HB 2925—90 day prescription coverage mandate: HB 2925 requires insurance companies to pay for a 90 day supply of prescription medication, whether the drug was purchased through mail order or at retail.  Although the committee seemed open to the concept, amendments are needed to clarify the bill.

HB 3000—Autism mandate: HB 3000 is the result of more than a year of work by the legislatively appointed autism task force.  The task force was charged with developing a comprehensive plan for autism treatment in Oregon.  The bill requires that insurance companies pay for a treatment called Applied Behavior Analysis.  Significant questions exist on the efficacy of this treatment, and the Oregon Health Resources Commission has issued a report saying that there is no solid evidence to support its use.    HB 3000 has a work session scheduled April 24, 2009.

Associated Oregon Industries