The Idaho Senate is looking at requiring health insurance to cover replacing and repairing prosthetic limbs and devices.
Rexburg Republican Sen. Brent Hill said adding new demands for insurers is something he normally opposes. “This is a health insurance mandate and we hate health insurance mandates,” he said Tuesday. Idaho has the fewest health insurance mandates in the nation, according to the Council for Affordable Health Insurance. “But maybe, just maybe, this is one we need to keep in mind,” Hill said. “It’s one small step to regaining the public confidence in our current health care system.”
Hill said some insurance providers don’t provide complete coverage for amputee’s prosthetics. “Although they claim to cover prosthetics,” he said, “there are a few (providers) that refuse to pay for claims or repairs to prosthetic devices.” Hill didn’t name any providers that don’t offer that coverage. His plan would mandate all state-regulated health care plans to cover repairs at the same level that Medicare dictates. That would mean replacing or fixing prosthetics due to physical changes, like a child growing up, or when a doctor says it’s medically necessary.
Hill said he got the proposed legislation from Bonnie Jensen with the Idaho Amputee Coalition. She told IdahoReporter that more than a dozen other states, including Oregon, have passed similar laws in the past three years. The new mandate would help a third of the 7,500 amputees in Idaho. For those companies that don’t include prosthetic repairs, Jensen said health care premium costs would rise from 12 to 25 cents per $1,000.
The Senate Commerce and Human Resources Committee voted unanimously to introduce Hill’s proposal, though some on the panel expressed concerns. “We are faced with complicated decisions between trying to keep premiums low and trying to keep coverage there that is needed and promised,” said Sen. Dean Cameron, R-Rupert. He echoed Hill’s concern about adding a new health care mandate.
Another concern is that not all health care plans are regulated by the state. Some employer-run insurance plans are exempt from state rules due to a federal law called Employee Retirement Income Security Act (ERISA). “We don’t have any oversight over health care plans that are offered by ERISA,” said Sen. John Goedde, R-Coeur d’Alene. “There are bad players out there but it’s hard to narrow down which ones we have oversight over.”
“The additional mandates we make therefore create a more unlevel playing field,” Cameron said. “The problem is it puts employers at an uncompetitive disadvantage if they are buying their coverage from a regulated insurance company versus one that’s not regulated.”
Hill agreed that the new mandate wouldn’t apply to some insurance plans in Idaho. “We can’t regulate all insurance companies, but the ones we do regulate, there’s a reason why we regulate them. It’s to provide just, reasonable insurance coverage.” Hill’s proposed mandate will likely come back to the Senate Commerce and Human Resources Committee for a full hearing.
Gov. Butch Otter signed an Idaho Amputee Coalition proclamation in a short ceremony Tuesday morning. On Friday, the coalition has an event planned on the fourth floor of the Capitol Rotunda.