Originally created 02/17/99

Senate softens up insurance mandate



ATLANTA -- On the eve of Gov. Roy Barnes' unveiling of his managed care reform plan, the Georgia Senate on Tuesday watered down a proposed health insurance mandate.

Insurers say Mr. Barnes' proposal, which would give consumers the choice of doctors they see and make HMOs subject to unlimited lawsuit awards, could force premiums up as much as 17 percent.

In addition, Mr. Barnes' insurance reform does nothing to stop the kind of mandated coverage that industry officials say has driven up health care premiums.

About one-quarter of Georgians are covered by managed care plans.

Voting 40-5, senators passed legislation Tuesday suggesting insurers cover the treatment of morbid obesity.

The original version of the bill would have required the coverage, but the Senate Insurance and Labor Committee changed the language to merely make it a suggestion. Committee members were concerned that such a requirement would drive up premiums, said state Sen. Eddie Madden, D-Elberton, the panel's chairman.

"We're taking a close look at ... mandating requirements on insurance (coverage)," Mr. Madden said. "We want to make sure the cost of health insurance is affordable to those Georgians who have the hardest time obtaining it."

But even the watered-down bill was too much for state Sen. Clay Land, one of five senators who voted against it.

"I don't think we ought to be mandating that insurance companies provide that specific type of coverage," said Mr. Land, R-Columbus.

Mr. Barnes railed against insurance-owned HMOs throughout his gubernatorial campaign last year, promising to give Georgians the right to choose the doctor they see.

His proposal would do just that, although consumers likely would have to pay higher premiums to get that choice. An HMO customer could see any doctor as long as the physician agrees to the conditions of the plan, such as the fee.

Currently, HMO patients see doctors who have agreements with the company.

If an HMO denies coverage of treatment, a patient could appeal to an external review panel made up of doctors independent of the managed care company. That review panel's decision would be binding. The average health insurance plan costs employers and employees about $3,600 a year per employee, according to the Georgia Association of HMOs, so a 17 percent increase would raise the cost $612.

However, Mr. Barnes says that's the kind of overblown, doom-and-gloom rhetoric of lobbyists lying to the public.

James Salzer and Dave Williams are based in Atlanta and can be reached at (404) 589-8424 or mnews@mindspring.com.