DENVER– Two Denver Democrats reluctantly diluted the bill they co-sponsored aimed at expanding maternity coverage in Colorado. The move took attendees at the House hearing for the bill Wednesday by surprise. Health insurance lobbyists shuffled their papers and gazed at one another as Reps. Jerry Frangas and Beth McCann explained that they would amend the bill to make it more friendly to the insurance industry in order to make sure it passed through committee and onto the floor of the House.
“ We need to take a step,” McCann told the Colorado Independent. “We can discuss further steps, but we need to get this going so that women and families can at least have an option. We felt that after speaking to members of the committee and representatives of the insurance industry that we would be able to get the ball rolling if we didn’t mandate [coverage] for every policy,”
The bill would have required that all individual insurance plans in the state cover maternity care and contraception, the way group plans do, but the amendment altered the bill to demand that all insurance companies offer at least one plan for individual policyholders that includes maternity care. Contraception is not included in the present version of the bill. The new version passed out of the House Business Affairs and Labor Committee with all 11 committee votes.
In her remarks introducing the bill, McCann cited reporting by the Colorado Independent on the frustrating gender inequalities and gaps in coverage that mark the individual health insurance market in the state.
“I don’t know if any of you have seen it… there was an article in the Colorado Independent about a reporter who posed as a 34-year-old woman trying to get maternity coverage in the rural areas and her experience was very frustrating… Either the policy was not there at all or it only covered a very small portion for quite a bit of money and then if there was a complication the policy might not cover that. So, this is a problem.”
Supporters of the original version of the bill said they cast their votes with a sense of disappointment.
”For the record, I don’t like this amendment. I’ll go with it….the fact that we are making maternity coverage an option, I struggle with that. I am going to go with it for the sake of the bill…but I think that a lot of costs are driven by the fact that things aren’t covered,” Rep. Karen Middleton, D-Aurora, said. She said the whole point of insurance is to spread the costs to lower prices.
Frangas told the Colorado Independent that 29 states currently have some type of maternity coverage mandates. The 1978 Pregnancy Discrimination Act mandates that all employers providing health care plans covering more than 15 people provide maternity care. In Colorado, the market for individual coverage for women provides coverage so incomplete and unreliable that many insurance agents will not recommend the available policies, as the Colorado Independent reported in the fall.
Twenty-five percent of women in Colorado currently pay for maternity care out of pocket. One in five children are born on Medicaid here and one in five pregnant women did not receive proper prenatal care. Frangas said that, whatever else you might think about it, these kinds of lapses cost the state a great deal of money. He said the costs of women’s death in labor, birth defects and premature birth were serious and demanded coverage. He said despite the amendment the bill works toward change.
“Currently it is difficult to get these policies, this will at least make them available.”
McCann also stressed that prenatal care is the best way to head off expensive and sometimes tragic complications to pregnancies.
“If someone is not covered and cannot afford to be, complications do not get caught and they end up with the inability to deliver a healthy child or have a child that has difficulties… To me it just makes sense– from an economical view, a personal and emotional point of view– that we would want our citizens to have available policies that would provide this important coverage.”
Sharlene Yabe , south chapter legislative chair for the Colorado State Association of Health Underwriters, an organization that was working to create a moratorium on health care mandate legislation earlier this year , said her organization is happy to see the compromise. She added that she was unhappy that the bill might end the industry practice of counting pregnancy as a pre-existing condition.
“We want to avoid high rates that push up the numbers of uninsured in Colorado.”
She said Coloradans aged 19 to 39 could see health premiums increase by 20 percent if insurance companies were forced to cover maternity and that those increases could go as high 50 percent if pregnancy could no longer be rated a preexisting condition.
Liza Meyers, who represents the Colorado section of American Congress of Obstetricians and Gynecologists, testified that the Colorado Medical Society and the Colorado Academy of Family Physicians support the bill. She said it prevents patients from forgoing prenatal care due to out of pocket costs.
Advocates say the bill would have reduced the inequalities in cost that break down in the state along gender lines. The original mandates in the bill would have spread out the cost of maternity and contraception to men pushing the costs down by spreading them to the other half of the population. On that score, the bill would have worked in tandem with legislation being introduced Thursday aimed specifically at creating gender equality.
Committee Chair Joe Rice, D-Littleton, said the bill would increase the pool of individuals using policies that include maternity care and so would increase competition for those policies and slash costs He acknowledged that the plans the bill would make insurance companies offer to cover maternity care would likely be high priced plans, which would steer women away from the plans. He said he feels the bill is a stepping stone.
Tonni Panetta, director of political affairs for NARAL Pro-Choice America, said there was time to strengthen the bill.
“There will be many more opportunities to engage and to put together a responsible policy for women and their families who are buying insurance in the individual market place.”