HCS HB 855 -- HEALTH INSURANCE

SPONSOR:  Holand

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 12 to 1.

This substitute changes the laws regarding insurance coverage for
mental illness and chemical dependency.  In its main provisions,
the substitute:

(1)  Requires all health plans or policies that are individually
underwritten or that provide coverage for specific individuals
and their family members to provide coverage for the treatment of
alcoholism.  Various group policies are excluded from this
requirement.  This provision will become effective January 1,
2005;

(2)  Revises provisions contained in Sections 376.810 - 376.814,
RSMo, pertaining to the offer of insurance coverage for the
treatment of chemical dependency.  This provision requires all
health plans or policies that are individually underwritten or
that provide coverage for specific individuals and their family
members to provide coverage for the treatment of chemical
dependency.  Various group policies are excluded from this
requirement; and

(3)  Revises provisions contained in Sections 376.825 - 376.840,
the Mental Health and Chemical Dependency Insurance Act.  All
health plans or policies that are individually underwritten or
that provide coverage for specific individuals and their family
members can offer the coverage listed in this section.  Various
group policies are excluded from this requirement.  This
provision will become effective January 1, 2005.

The substitute also requires health carriers that offer health
benefit plans in this state on or after January 1, 2005, to
provide coverage for mental health conditions.  Mental health
conditions are defined as those listed in the most recent edition
of the Diagnostic and Statistical Manual of Mental Disorders.
Coverage for mental health conditions cannot have rates, terms,
or conditions that place a greater financial burden on an insured
for mental health treatment than for physical health treatment.
This provision of the substitute does not apply to certain
insurance policies, including individually underwritten insurance
policies.

FISCAL NOTE:  No impact on General Revenue Fund in FY 2005, FY
2006, and FY 2007.  Estimated Net Cost on Other State Funds of
$145,209 in FY 2005, $315,610 in FY 2006, and $325,079 in FY
2007.

PROPONENTS:  Supporters say that the bill makes no distinction
between insurance coverage for biological and psychological
illnesses.  More effective treatment for mental illness is
currently available; and the trend is to treat patients on an
outpatient basis, thus lowering mental health care costs.
Persons with dual diagnoses and persons with low to moderate
incomes often have difficultly accessing adequate mental health
services due to inadequate coverage, benefit limits, or the
exhaustion of benefits.  Finally, the bill contains cost control
features, including the administration of the insurance coverage
by a managed care organization and making medical necessity the
basis for mental health treatment.

Testifying for the bill were Representatives Holand and Riback
Wilson (25); Department of Mental Health; Missouri Coalition  for
Community Mental Health Centers; Boone Hospital Center; Missouri
Statewide Parent Advisory Network; Eastern Missouri Psychiatric
Society of St. Louis; Missouri State Medical Association;
National Alliance for the Mentally Ill of Missouri; National
Alliance for the Mental Ill of Columbia; Missouri Hospital
Association; Missouri Association of Physicians and Surgeons;
American Federation of State, County, and Municipal Employees;
Edward Duff; Kelly Schultz; National Alliance for the Mentally
Ill of Joplin; United Healthcare; Citizens for Missouri's
Children; and Paraquad.  Additional testimony was submitted by
the Mental Health Association of Pettis County; Missouri
Association of Marriage and Family Therapists; American
Counseling Association of Missouri; Missouri Nurses Association;
and Mental Health Commission.

OPPONENTS:  Those who oppose the bill say that mandating
insurance coverage for mental illness will result in a cost
shifting from the private to the public sector, termination of
insurance coverage, increased insurance premiums for consumers,
and modifications in insurance coverages for biological
illnesses.  The bill will affect small businesses by increasing
health insurance costs.

Testifying against the bill were Blue Cross/Blue Shield of
Missouri; Missouri Association of Health Plans; Missouri Chamber
of Commerce and Industry; Associated Industries of Missouri;
Golden Rule Insurance Company; American Family Insurance; and
Missouri Insurance Coalition.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:14 am