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Minutes for HB2103 - Committee on Insurance

Short Title

Providing insurance coverage for amino acid-based elemental formula.

Minutes Content for Thu, Feb 9, 2017

Mr. Smoot testified they were opposed to HB 2103. He said they were sympathetic that people would like their food sources paid for but there was a long-standing tradition not to have insurance companies pay for food items. He said the proponents did not provide a cost analyst as set out in Kansas law. He also said the bill was open-ended in that potentially an insurer might have to pay for over-the-counter-products for a lifetime. He added that coverage would mostly effect smaller employee groups and smaller marketplaces. He concluded by saying in insurance pools, the cost was divided equally and increased premiums hit the poorer policyholder harder (Attachment 6).

Chairperson Vickrey opened the meeting for questions.

Representative Cox asked Mr. Smoot, regarding the $31 per plan per year for hearing aids, whether that was the cost per month or per year.

Mr. Smoot said it was an increase per year.

Representative Cox asked if this considered a person would only need hearing aids every five years.

Mr. Smoot replied that most states provided a cap on what is paid per year.

Representative Cox asked whether coverage would be more amendable if there was language specifying a cap on services.

Mr. Smoot answered it was an improvement but currently BC/BS stood firm on opposing mandated coverage.

Representative Cox asked what was being done to lower the cost of medical services.

Mr. Smoot answered that providers have agreed to accept reimbursement lower than they wanted to charge.

Representative Parker asked if Kansas policy owners assumed that insurance just covered major medical costs.

Mr. Smoot answered "yes" and that the federal government had defined what were essential health benefits.

Representative Parker said  as far as HB 2013, they had heard from proponents who suffered catastrophic costs and questioned whether formula should be included.

Mr. Smoot replied there was a specific exclusion in the policy. He acknowledged it was catastrophic for the family but they can't cover everything.

Mr. Parker added since it was a fairly new diagnosis, if patients didn't have an opportunity to shop around for a policy.

Representative Corbet asked if mandates were passed, whether it affected everyone.

Mr. Smoot said higher costs mostly affected small businesses and individual insureds.

Representative Elliott said wellness was a concern and asked how Kansas wellness ranked with other states.

Mr. Smoot answered the KDHE would be a better resource. He said utilization of medical services was what drove the cost. The healthier the population, the lower the utilization.

Mr. Epple asked, regarding hearing aids, whether an interim study be done to define cost and benefit. He said as far as HB 2103, he viewed it more a therapy than formula. He added infants and young children were most affected and wondered about an interim study to create a benefit package that could help them without a large cost.

Mr. Smoot said he encouraged fact-based study and analysis.

Representative Bishop said she knew there was a hearing loss that occured with age and was concerned an individual might end up with a product that didn't work. 

Representative Neighbor addressed Representative Elliott saying Johnson County was the healthiest county in Kansas and Wyondotte was the unhealthiest and the difference was based on social-economic differences. She asked Mr. Smoot if BC/BS was a for profit company.

Mr. Smoot answered it was a mutual company, they don't have stock or profits.

Representative Neighbor said she agreed they do need a test track and cost analysis for any mandate. She asked Mr. Smoot whether it would be more palatable if an analysis was done.

Mr. Smoot responded saying the more it was analyzed and researched the better. They were still concerned about possible appeal of federal mandates.

Chairperson closed the hearings on HB 2102 and 2103.