Health-insurance bill gets qualified support

February 23, 1991|By David Conn | David Conn,Annapolis Bureau of The Sun

ANNAPOLIS -- Janet Harris, whose husband works for the Johns Hopkins University, is about to become the wife of an unemployed man. The couple can barely afford their current health insurance plan and conceivably could benefit from a less expensive policy, even if it offers less than the full array of state-mandated benefits.

But, as Ms. Harris told a House panel yesterday, the bill the lawmakers are considering to allow insurers to offer a stripped-down health-insurance package would leave families such as hers out in the cold and provide far fewer benefits than they need.

When the Catonsville resident gave birth to her daughter, Juliet, last summer, Blue Cross ended up paying only $1,346 of the total $3,000 bill. The stripped-down, or basic benefits plan, would give her even less coverage, she believes.

"I've been watching the insurance system of financing health care fall apart before my eyes," she said, as Juliet fidgeted in her arms. Ms. Harris' was the most dramatic testimony in opposition to House Bill 1120 yesterday. But with the entire House Economic Matters Committee co-sponsoring the legislation to allow insurers to sell a less-expensive basic health-benefits plan, the strategy of the day was to support the bill -- with amendments.

The bill would allow insurers to offer a basic-benefits policy to individuals and small employers (two to 25 employees) who have not had any insurance for the previous 12 months. No one could keep the plan for more than three years.

Because the Harrises have been covered by a policy that Hopkins offers, they wouldn't be able to buy the basic-benefits plan. And without Mr.Harris's income, they can't afford to continue the more expensive standard policy, Mrs. Harris said.

Committee Chairman Casper R. Taylor Jr., D-Allegany, acknowledged that the bill is only a first step in addressing the problem. The suggested amendments by and large came from health-care providers who want to add to the minimal schedule of benefits laid out in the bill. Everyone who testified supported the bill's goal: trying to reach some of Maryland's roughly 570,000 uninsured, about 74 percent of whom are employed or dependents of employed people.

The plan would offer coverage for 10 inpatient hospital days a year, 10 outpatient physician's office visits, prenatal and maternity coverage and emergency-room care. Some of the doctor's office visits could be used for preventive tests and child wellness services.

Bruce Martin, one of Gov. William Donald Schaefer's legislative aides, said the administration would like to see the bill beefed up enough to reflect the recommendations of the Governor's Commission on Health Care Policy and Financing, known as the Feinblatt Commission.

That group called for a basic-benefits policy that offered at least seven days of mental health outpatient visits; unlimited doctor's office visits; and, for women over 50, at least one mammogram in the three-year period of coverage.

Lobbyist Ira C. Cooke pointed out that the language in the bill precludes patients from using their 10 outpatient days to visit less expensive non-physician providers, such as optometrists and physical therapists, two groups he represents.

Casey Hughes, lobbyist for the Maryland Psychological Association, and Barbara Brocato, who spoke for Maryland's social workers, said the bill does not address the need for mental-health and other non-physical care.

And Andrew Wigglesworth, lobbyist for the Maryland Hospital Association, noted that other states that have tackled the issue of a basic-benefits plan have been more generous with hospital days. The Virginia plan, for instance, provides coverage for 30 inpatient days a year, he said.

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