Health insurance bill deals with maternity care

By Anthony Bowe

A bill requiring all Colorado insurance companies to offer maternity and contraceptive care to female policy holders is hitting road blocks as sponsors from each chamber differ on a key provision.

House sponsor Rep. Beth McCann, D-Denver, said the bill, House Bill 1021, could be headed toward a joint conference committee if the differences can’t be worked out.

“I am hoping that we can get it out of the Senate in a similar form that it passed the House,” McCann said this week.

The lynchpin provision is one mandating the number of individual policies an insurance company must offer with maternity and contraceptive care. Large and small group sickness and accident insurance policies already are statutorily required to offer maternity care in most cases.

The bill passed by the House mandates that all policies include maternity and contraceptive care as a core benefit. But an early version from the Senate Business, Labor and Technology Committee mandated that only one policy was required for the care. All versions of the bill would eliminate pregnancy as a pre-existing condition and require individual and group sickness and accident insurance policies to include contraceptive care.

Senate sponsor Sen. Joyce Foster, D-Denver, said she might have found a compromise. Foster amended the Senate committee report before the bill’s second reading Thursday, changing the controversial provision to include a majority of policies mandating the natal services.

The bill passed on a voice on second reading on Thursday.

“On my side of the aisle they are happier. On the other side of the aisle, it’s a requirement — it’s a mandate still. So they’re not going to be happy,” Foster said.

McCann said she and fellow sponsor Rep. Jerry Frangas, D-Denver, have not determined whether that provision is agreeable to the House.

The bill, crafted by the Colorado Health Care Task Force, is riding through the General Assembly on a wave of Democratic support. Not one House Republican voted in support of the measure on its third reading last month and the bill narrowly passed the Senate Business, Labor and Technology Committee on a 4-3 majority victory.

Maternity coverage commonly includes prenatal care, outpatient prenatal care, inpatient delivery, and outpatient postpartum care. Contraceptive care includes birth control products to prevent unwanted pregnancies. Abortion coverage is not included in the legislation.

Sen. Shawn Mitchell, R-Broomfield, said Republicans oppose adding more mandated burdens to the insurance industry.

“There are a lot of well intended ideas that make insurance more expensive for everyone,” said Mitchell, who voted against the bill in the Senate Business, Labor and Technology Committee.

Foster said the bill is a matter of adding fairness in the individual market, which she said places single women into plans which cover prostate coverage.

“What about all those single women out there who do not need prostate coverage? They’re already paying for it,” she said. “This is a discussion of fairness, equity and healthier babies.”

Insurance companies protesting the House and current Senate bills believe the early Senate committee version makes more sense. Robert Ferm, legislative counsel for insurance provider Aetna, said maternity care for all or a majority of plans would result in insurance companies losing the young male demographic, which he said would increase premiums.

Ben Price, executive director of Colorado Association of Health Plans (CAHP), a health insurance lobby group, agrees.

“Their (young males) presence in the individual insurance market is so vital to lowering the overall risk in the pool and keeping insurance affordable for everyone,” Price said.

While insurance companies typically resist any mandate on coverage, Price said maternity coverage in individual policies is achievable.

“Maternity coverage is something we can do in a reasonable way, but there need to be parameters within the language,” he said.

Foster’s amended provision mandating a majority of policies to require maternity care still “doesn’t make sense as a matter of public policy,” Price said.

“That would require a carrier that’s going to offer any type of plan to offer two more that cover maternity, so three plans for every one plan in expansion,” he said. “We think that could make it difficult for some of our carriers to contemplate expanding their business to cover more people in this market in Colorado.”

Proponents of the bill said it would give access to maternity care to more women and, in turn, increase the consumer base for health carriers.

“By requiring [the mandate] of all of [the carriers], I think it sets up market competition and I think that competition will help keep the rates down a little bit,” said Sen. Betty Boyd, D-Lakewood, a co-sponsor on the bill. “I think if they’re competing with other insurance companies they might not be raising it quite so much because they’ll certainly want the business.”

Increasing the health of newborn babies in Colorado is also a major concern, proponents and dissenters agree.

The National Women’s Law Center said one out of every five Colorado women did not receive prenatal care during the first trimester of their pregnancies in 2007. The Colorado chapter of March of Dimes reported last year that one in 8 babies in the state are born premature.

“The bill is not just for the women of Colorado. It’s for women, it’s for couples, it’s for men and primarily healthy babies,” Foster said.

Another snag in the bill for insurance companies and state Republicans is deciding when a pregnant woman can opt in to a policy with maternity care. Ferm said the bill would allow women opt in to a policy only within weeks of giving birth.

“If you’re going to opt in only when you think you have a problem, like at seven months, that’s not a proactive way to manage the pregnancy,” he said. “We’re not saying someone shouldn’t have a choice, we’re just saying they should set some reasonable restrictions to encourage people to get involved in maternity care at an early stage.

“The results then will be a healthy mother and a health baby,” Ferm said.

Mitchell said women who opt in late would cause an increase in premiums.

“It’s not really insurance, it’s just mandating cost shifting from previously uninsured people to current rate payers, current premium payers,” the senator said on Wednesday prior to the bill’s second reading. “That problem was fixed in the committee version of the bill but I understand Sen. Foster wants to go back to her catastrophically expensive version of the bill and I’ll fight that move on the floor.”

Pregnant women deserve the benefit of the doubt and are responsible enough to opt into plans early, Foster said.

“I’m going on the premise that wome­n are being honest about this, they’re going in for good prenatal care, they want help, they want support and they want good healthy baby coverage afterward, so they’ll stay in the system,” she said.

Boyd said she thinks Democrats will continue carrying the bill to Gov. Bill Ritter’s desk despite opposition.

“I suspect probably it will pass. I’d be surprised if it didn’t,” Boyd said.

Similar bills are included in the federal health packages coming out of the House and Senate, Foster said.

“We’re ahead of the curve. I like to be on the cutting edge,” she said.

Pro- Choice Lobby Day

Determined volunteers with Planned Parenthood of the Rocky Mountains swarmed the Capitol in support of HB 1021 Wednesday as a part of the pro-choice lobby day.

“We’re out here today with 60-plus of our supporters who all dedicated their time and energy to come out,” said Monica McCafferty, spokeswoman for the organization. “Lobby day is great for our supporters because they really see how the legislative process works and they see what happens behind the scenes.”

McCafferty said approximately 15 to 20 other pro-choice groups joined in. The group was specifically lobbying senate Democrats and Republicans to replace the House mandate provision in the bill. She said volunteers met with the sponsors of the Senate bill along with Senators Rollie Heath, D-Boulder, Nancy Spence, R-Centennial, Pat Steadman, D-Denver, Michael Johnston, D-Denver, Paula Sandoval, D-Denver, and Rep. Daniel Kagan, D-Englewood,

“Right now there’s a huge gap in the individual market for women,” she said. “It’s a crucial bill for Colorado families, and crucial to have healthy pregnancies and healthy families,” she said.

Leslie Hanks, vice president of Colorado Right to Life (CCRL), an anti-abortion organization, detested the lobbying event. Hanks said CCRL was too busy acquiring signatures for it’s Personhood amendment to protest Planned Parenthood’s lobby day.

“Of course we oppose any funding of child killing, in whatever form it takes,” Hanks said in an email Tuesday. “We are in overdrive getting signatures, so we won’t take time from that to protest evil PP tomorrow.”

The Colorado Catholic Conference, which also opposes abortion, is lobbying against the bill, as well, but could not be reached for comment.

Mary Parker, 62, a Colorado transplant originally from a Washington D.C. suburb in Maryland, said Planned Parenthood’s lobby day was her first time being in the state Capitol.

“My number one goal was to meet with my own senator (Sen. Mike Kopp). I did go to his office and left a letter because he wasn’t there,” Parker said. “Number two goal is to meet as many other senators and people who are working on the bill to find out how it’s going and find out how I can help it.”