DULUTH NEWS-TRIBUNE
Copyright (c) 1999, Duluth News-Tribune

Monday, May 10, 1999
By Daniel Bernard/News-Tribune staff writer

TINKERING WITH INSURANCE LAWS
DULUTH LEGISLATOR CRIES FOUL AS LAWMAKERS CONSIDER EASING MANDATES FOR SMALL HEALTH INSURERS

   ST. PAUL -- Minnesota's rules requiring insurance companies to provide certain types of coverage have grown increasingly complex.
   Now lawmakers are on the verge of approving an experiment that would let the state scrap the old rules and start from scratch for certain insurers that provide policies for the employees of small businesses.
   But not before a fight on the House floor that could come Tuesday. Rep. Tom Huntley, DFL-Duluth, said the Legislature should ensure that some treatments still are covered.
   ``We have to provide some guidance,'' Huntley said.
   Under legislation eligible for final passage this week, the state Commerce Department would design new, minimal rules for policies that insurance companies with a small share of the market could offer to businesses with fewer than 50 employees.
   Boosters say the plan would spur competition at a time when 85 percent of the insurance market is controlled by three companies -- Medica, Health Partners, and Blue Cross Blue Shield -- while creating less expensive options for small employers and perhaps reducing the ranks of the uninsured. The effectiveness of the pilot project would be assessed after three years. But as appealing as the fell-swoop red-tape reduction sounds, the difficulty is in the details.
   For instance, the old rules -- which the small-business policies would not necessarily have to follow -- require insurance plans to provide maternity benefits for the employee. Other regulations require insurers to cover routine screening for breast and cervical cancer; immunizations for children; and other services that no layperson with a heart would deny to anyone they know.
   Just before the experimental proposal passed the Minnesota House last week, DFLers offered 29 amendments to put some of those mandates back in. They included maternity benefits, cancer screening, child immunization, newborn care and a guarantee that new mothers can stay in the hospital at least 48 hours after giving birth. Other amendments said the new policies must pay for outpatient mental health treatment, for cleft palates, direct access to obstetric and gynecologic services, and breast reconstruction after mastectomies.
   Faced with a public vote, the majority Republicans overwhelmingly approved the add-ons. But the changes blew the concept of low-mandate insurance, said Rep. Bill Haas, R-Champlin, the bill's sponsor.
   ``What happened on the House floor was political gamesmanship,'' Haas said. ``One of my DFL colleagues took me aside and told me, ``We're going to make you take 29 bad votes on all the amendments, and then we're all going to vote for the bill anyhow.''
   Haas said the Commerce Department should have the option of authorizing perhaps three different policies with few mandates, fewer mandates and no mandates. Haas, who by profession brokers insurance policies for employers, said all the new policies would include maternity benefits because of an existing state law. Under House tradition, Haas would have lost at that point. Heading into a House-Senate conference committee, a legislator is expected to attempt to uphold the version of the bill as it was approved by his or her chamber.
   Yet when Haas emerged from the conference committee on Thursday, the bill was in its original version -- the way it had been introduced by Haas and passed by the Senate, without the House amendments.
   When the conference committee's product is reported to the House for final ratification as soon as Tuesday, Huntley plans to accuse Haas of bad faith.
   ``He didn't even offer any of the House positions,'' said Huntley, a medical school instructor at University of Minnesota-Duluth.
   ``If Haas had made an agreement that they would start with the Senate position, obviously, he's subverted the conference committee process.'' Haas said he and fellow conferee Rep. Greg Davids, R-Preston, decided not to fight for the mandates because the House amendments had been politicized.
   ``In order to make this plan work, we have to have it go in with no mandates,'' Haas said.
   Huntley said leaving out many of the mandates would hurt women in the work force because they would have to ask for coverage, making them look more expensive in the eyes of the employer. Commerce Commissioner David Jennings said the new policies will be sure to cover medical necessities.
   Sen. John Hottinger, DFL-Mankato, agrees with Haas.
   ``What happens in the Legislature too often is, one event triggers this kind of dramatic response. One legislator that can come up with an anecdote that grabs your heart strings can get us to adopt policies that aren't that thoughtful,'' Hottinger said. ``Each mandate taken individually sounds like a good idea. But it drives up the cost of insurance.''