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Health Regulation Bombs in Legislature

State Capital Bureau

May 12, 1995

JEFFERSON CITY _ When Gov. Mel Carnahan in January abandoned his push for health-care regulation this legislative session, he predicted that another health care fight in the General Assembly would be futile because of insurance-industry opposition.

The events of the session seem to confirm Carnahan's point.

Insurance industry opposition was blamed for the death of the few major pieces legislation offered this session to regulate health-coverage plans.

No sweeping health-care packages similar to Carnahan's original proposal of last year were even offered.

The piece of legislation that most closely resembled Carnahan's original proposal was the "Health Insurance Access Act." The act, offered by Sen. Ed Quick, D-Kansas City, was a scaled-down version of the governor's proposal.

Quick's proposal would have impose several requirements on insurance companies designed to increase access to health care insurance for all Missourians.

Among the provisions, insurance companies would be restricted from denying coverage because of pre-existing conditions. And, the companies would be required to charge standard rates for standardized policies.

The act was only briefly debated in the Senate. Quick agreed to end discussion of the bill after just 15 minutes so as not to delay debate on bills scheduled to be discussed later that day.

During the short debate, the Senate Republican leader offered an approach that was scaled down to an even greater degree.

The alternative, offered by Sen. Franc Flotron, R-St. Louis County, would only limit exclusions based on preexisting conditions and allow policy holders to keep their insurance when they change jobs.

Both the act and Flotron's substitute failed to reach a final vote.

The other major health-care regulation bill of this session, the "Patient Fairness Act," was bottled up in the House Insurance Committee after being approved by the Senate.

The measure, sponsored by Sen. John Scott, D-St. Louis, would have required Health Maintenance Organizations, or HMOs, to explain their benefits plans in easily understood terms.

The act also would have required HMOs to accept applications from all physicians in their geographic areas and inform them of the reasons used if their applications are rejected.

Scott said his bill was killed by insurance industry lobbyists, just as Carnahan blamed similar opposition for the failure of last year's health regulation efforts.

One lobbyist did not object to Scott's assignment of blame for his bill's death.

"We worked damn hard to kill it," said Randy Scherr, a lobbyist for Prudential Insurance Company.

Even health care programs authorized two years ago ran into trouble in this session when they became entangled in the controversy over abortion rights.

House Speaker Bob Griffin, D-Cameron, sponsored legislation in the 1993 session to provide grants to assist public school health services. The grants were supposed to have been funded by taxes on cigarettes, but by this session additional funds were needed to continue the grants.

Because the cigarette tax did not generate enough funds for the program, the governor urged lawmakers to approve legislation that would let the legislature provide additional funding to the program.

But it got wrapped up in the anti-abortion controversy. In the House, the sponsor dropped further efforts for the bill when an anti-abortion amendment was tacked on.

Each side blamed the other for killing the bill.

"This legislation was killed off by anti-choice extremists more interested in furthering their own narrow ideological agenda than with providing important health services to Missouri's school children," Carnahan charged.

But the other side charged it was abortion-rights advocates, including the governor, who killed the bill because they refused to accept the House-approved anti-abortion amendment.

One health-care bill that was actually killed by a vote, rather than by the General Assembly's inaction, was the bill to provide health-care coverage to all Missourians, sponsored by Rep. Mary Bland, D-Kansas City.

The measure was defeated by a vote in the House in late April.

Rep. Ron Keeven, R-St. Louis County, offered a health-care proposal early in the session, but then withdrew the bill on the day it was supposed to have been heard in committee.

"We were concerned that the Democrats would take the bill and change it so it conformed to their more socialist agenda and then try to paint it as a Republican bill," said the bill's co-sponsor, Glenn Hall, R-Grain Valley.

The measure would have required all Missourians over age 18 to have health insurance and would have allowed Missourians to deduct out-of-pocket medical expenses from their state taxes. It also would have banned insurers from refusing coverage based on preexisting conditions.

The few health-care bills that passed during this session were relatively minor. Among them, one measure required health insurance plans to cover breast cancer treatments, chemotherapy and bone marrow transplants.

Another bill exempted nursing homes for AIDS patients from the certificate of need requirements for expanding their facilities.

Another health-care bill, already signed by the governor, permits physicians to prescribe controlled substances for therapeutic purposes for persons who are in intractable pain. Pain is intractable if it cannot be cured or treated by a generally accepted course of medical practice.