Panel backing adoption of 2 new health benefits

March 08, 1991|By David Conn | David Conn,Annapolis Bureau of The Sun

ANNAPOLIS -- Last year, when the General Assembly considered adding to the list of mandated health insurance benefits, business groups and insurance companies managed to defer the debate: "Set up a commission to sit down and study the merits of these new mandates and wait until next year," they said.

Now it's next year.

Advocates of new mandated benefits for child wellness services -- including immunizations, developmental assessments and health screenings -- and for mammography tests for women 35 and older, marched before the House Economic Matters Committee yesterday with the fruits of last year's delay.

The Interdepartmental Committee on Mandated Health Insurance Benefits, created by the General Assembly last year, has finished its reports on those two benefits and decided they save businesses money in the long run.

A similar bill to create a benefit for serious biologically based brain diseases, such as schizophrenia, does not yet have the endorsement of the committee, which is still studying the issue.

Legislators have acknowledged that the Economic Matters Committee is likely to pass the first two benefits this year, largely because of the benefits panel's recommendation.

Delegate Anne Marie Doory, D-Baltimore, who sponsored the bill to require insurers to offer coverage for child wellness services, said that "the expert panel on this issue . . . basically said the child wellness services are cost-effective."

The panel has reported that about 56 percent of Maryland children entering the first grade have not been properly immunized, Delegate John P. Donoghue, D-Allegany, said.

But Blue Cross and Blue Shield of Maryland Inc. argued that immunizations are available at Health Department offices throughout the state and that the real problem, if there is one, lies with parents who do not take advantage of the services.

And business groups complained that new benefits are the last thing employers need at a time when health care costs are rising 20 percent to 30 percent a year.

Advocates of mammography screenings for women 35 and older also were able to point to a positive recommendation from the committee on mandated benefits. Delegate Joan Pitkin, D-Prince George's, the primary sponsor of a bill to mandate that benefit, noted that more than 40,000 women each year in the United States die of breast cancer, more than 800 of them in Maryland.

Yet "61 percent of women in Maryland don't get mammograms && because physicians aren't referring them, and physicians aren't referring them because insurance companies aren't paying for them," said Marsha Bienia, chief of the cancer control division in the state Department of Health and Mental Hygiene.

The benefit would cost only about 40 cents a month per individual, according to Blue Cross lobbyist Fran Tracy. But both she and Miles Cole, lobbyist for the Maryland Chamber of Commerce, opposed the bills. "There are other reasons why people don't get mammograms" than a lack of mandatory insurance coverage, Mr. Cole said. "There are other reasons why people don't have their children immunized."

Maryland already has more mandated benefits than any state in the nation, and businesses cannot afford more, said J. T. Mullin IV, of Mullin Custom Clothing in Baltimore. He represents the Elected Advocates of Small Business in Maryland, a group of 16 small businesses.

"What we are looking for is to be able to control our health #F insurance costs," Mr. Mullin said.

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