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Restriction on insurance coverage mandates passes NC Senate

Sen. Jim Burgin, standing at left, presents his insurance mandates legislation to the full Senate.
Colin Campbell
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Sen. Jim Burgin, standing at left, presents his insurance mandates legislation to the full Senate.

The state Senate on Wednesday approved legislation that would restrict government mandates for health insurance plans, despite objections from some Democrats.

The bill was the first major policy bill to pass a chamber in the legislature this year, and it’s one of several proposals to reduce the high cost of healthcare in North Carolina.

Sen. Jim Burgin, R-Harnett and the bill’s sponsor, said forcing insurance plans to cover particular services drives up costs, and he said he's compiled a list of 58 such mandates in current state law. He told lawmakers considering new mandates that they’d need to review the list and find one to repeal.

"This will ensure that we're not imposing additional burdens on the health system," he said.

Proposed new mandates from the legislature would also have to come with funding for the State Health Plan to implement that change for state employees' healthcare coverage.

Burgin’s office to վ. Among the services that insurers are currently required to cover in North Carolina:

  • Hearing screenings for newborn babies
  • Ovarian cancer tests for women over age 25
  • Hearing aids up to a cost of $2,500
  • Bone mass measurements for osteoporosis screenings
  • Screenings for colorectal cancer
  • Coverage for certain clinical trials
  • Coverage for adopted children on the same basis as newborn children

The State Employees Association of North Carolina said it appreciates the effort to lower healthcare costs but questions the bill’s approach.

“Our concern with the bill is that it perpetuates the idea that covering procedures is what costs so much in NC compared to other states, and that’s simply not the case,” SEANC executive director Ardis Watkins said. “We earned the distinction of being the most expensive state in the country for healthcare by allowing the industry to overcharge, not by being overly generous with care. For instance, 33 states have expanded coverage for supplemental breast cancer screening but North Carolina does not. We are not paying obscene prices because we get more coverage than other states.”

The bill has support from groups like the N.C. Chamber and National Federation of Independent Businesses.

“Government-imposed mandates often lead to higher premiums, leaving (small business) owners with three bad options: absorb the cost, pass the cost on to employees, or stop offering coverage entirely,” NFIB state director Gregg Thompson said in a news release.

But 13 of the Senate's 20 Democrats ultimately voted against the bill. Sen. Jay Chaudhuri, D-Wake, said the limitation on coverage mandates would only apply to half of the insurance plans in the state. Others, such as plans offered by large national employers, wouldn't be effected.

"It is hard to tackle healthcare reform when you're only addressing half the marketplace, and it's hard to tackle health reform when you're only addressing one part of the puzzle — mandates — but not providers, access and drug costs," he said.

Chaudhuri proposed an amendment that would have instead launched a study on ways to reduce healthcare costs, but it was voted down along party lines.

"I feel like we don't need more studies," Burgin said. "We need to be taking action. We have so much money being spent on healthcare, and people are going without services because they can't afford to do it."

The bill now goes to the House.

Colin Campbell covers politics for վ as the station's capitol bureau chief.
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