Health Ins. Mandates Draw Strong Opposition

By CMTA Staff

Capitol Update, June 6, 2004 Share this on FacebookTweet thisEmail this to a friend

CMTA has consistently opposed legislation that would impose mandates on employer-provided health care plans because they add more cost and restrict an employer's ability to design plans that are affordable and tailored to the needs of their employees. The following bills contain such mandates and are opposed by CMTA.

Topping the list is SB 921 (Sheila Kuehl, D-Santa Monica), a bill that would create a single payer health care coverage program. The bill would provide a system of universal health care coverage for California residents whether they want it or not. The system would provide a one-size-fits-all health care benefits package with no regard to individual needs or preferences. Employers design their health insurance programs as a part of their overall compensation and benefits program in a manner to attract and retain good employees. SB 921 ignores this concept, requiring a generic plan to be forced upon employees and employers.

SB 921 would create the largest state health care bureaucracy in the nation, second only to the federal Medicare program. The bureaucracy would be funded by taxes on employers and employees. There is no reason to believe that this new bureaucracy would operate any more efficiently than the Department of Motor Vehicles, Department of Health Services, Department of Industrial Relations, Employment Development Department, etc. The bill is scheduled to be heard in the Assembly Health Committee on June 22nd.

SB 1192 (Wesley Chesbro, D-Arcata) would require employer health care plans to provide coverage for the medically necessary treatment of substance related disorders on the same basis as coverage for any other medical condition with one exception. A plan could limit non-hospital residential care to 60 days per calendar year. This would add enormous new costs and put employers at risk of losing federal and state contracts that require employers to certify "a drug free workplace."

This bill would negate cost containment provisions that limit access and duration of treatment in these plans by requiring the plan to cover substance-use disorders on the same basis as provided for any other medical care. CMTA is concerned because this would eliminate any incentive on the part of the enrollee to stop their abusive or illegal behavior because they would have unrestricted access to treatment at no cost to them. Moreover, in order not to violate this provision, it may require employers to violate the "drug free workplace" requirement. Even more importantly, it could put coworkers at risk of severe injury or death, undermining workplace safety, increasing production costs and dragging down morale by requiring employers to permit known substance user/abusers to continue working.

SB 1158 (Jack Scott, D-Altadena) would require employer health care plans to provide coverage up to $1,000 for hearing aids to all enrollees, subscribers, and insured under 18 years of age. While most plans provide for hearing loss, the amounts of reimbursement for hearing devices vary and this bill would set the mark at $1,000. This mandate would increase costs even if it was not widely used because insurers would want to be protected.

There are close to 6 million working Californians who are currently without health insurance. With a slowing economy, that number is expected to grow. Study after study confirms that the greatest barrier to health care coverage in the private sector is the high cost. All of the bills mentioned above exacerbate that problem. Moreover, these bills would provide an expensive benefit for employees who already have health care coverage. These new mandates will make health insurance even more costly and less affordable for employers and uninsured Californians.

CMTA urges you to contact your representatives and request that they vote no on these bills.
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