Thursday, September 6, 2012

State Insurance Commissioner Praeger urges establishment of `essential health benefits’

By SCOTT ROTHSCHILD, The Lawrence Journal-World

Health care officials on Wednesday discussed what should be included in insurance policies under the Affordable Care Act.

But as in most efforts related to federal health reform in Kansas, the proposal is in limbo.

"All of this really hinges on the election on Nov. 6," said Kansas Insurance Commissioner Sandy Praeger, one of the few Republicans in the country who has voiced support of the ACA.

President Barack Obama signed the ACA into law, and Republican presidential challenger Mitt Romney has vowed to repeal it.

Gov. Sam Brownback, a Republican, voted against the ACA while a senator, and is a frequent critic of the legislation. Last year, he sent back a $31.5 million grant in federal funds to set up a health insurance exchange under the law.

Now an ACA deadline is approaching that requires health insurance plans offered on the exchange to include a comprehensive package of services, called essential health benefits. States need to decide what benefits will be included.

Praeger said she will submit recommendations to Brownback who must decide by Sept. 30, but the governor has said he wants to see who wins the presidential race before he takes any further action on ACA requirements.

But Praeger said not deciding on essential health benefits now could limit Kansas' options in the future, should the ACA remain in law.

She said if Kansas doesn't pick its plan, then the U.S. Department of Health and Human Services will.

Dr. Pam Shaw, a pediatrician and professor at the Kansas University Medical Center, said pediatric care had to be included in insurance plans. Since children are developing, their health conditions "must be continuously monitored and reassessed," said Shaw, who was representing the American Academy of Pediatrics.

As a parent of an autistic child, Shaw said having that coverage under her state plan has been essential.

She was joined by other advocate groups, such as Kansas Action for Children.

But Eric Stafford, a lobbyist with the Kansas Chamber of Commerce, said he was concerned that too many mandates could increase the cost of insurance and cause some business owners to stop offering coverage to their employees. He said many businesses were already "at the tipping point."

Praeger said, "We want good coverage, but we want these products to be affordable. So, it's balancing the coverage versus the cost."

She said the overall goal is to reduce health care costs by providing the kind of services that can avoid more costly medical care later on.

Meanwhile, the Catholic Church submitted testimony urging the state not to require coverage for contraceptive services.

The ACA requires employer-provided health insurance provide contraception coverage. Obama has established an exemption for religious employers, such as churches, but Michael Shuttloffel, executive director of the Kansas Catholic Conference, said that exemption was too narrow.

"As has been repeatedly observed, not even Jesus Christ would qualify for this so-called religious exemption, since it excludes those who serve people of another faith," he said.