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Life Health > Health Insurance

Mastectomy-Related Laws In 3 States

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Governors have signed three major new mastectomy-related bills into law recently.

Virginia Gov. Mark Warner signed H.B. 662, a bill requiring state-regulated health carriers to pay for reconstructive surgery after mastectomies for breast cancer.

Indiana Gov. Frank O’Bannon signed H.B. 1111, a bill that requires certificates of coverage for group health coverage in Indiana to require reconstructive surgery, even if the certificate is linked to an insurance policy issued or delivered in another state.

West Virginia Gov. Bob Wise signed H.B. 2730, a bill requiring state-regulated health insurers to allow patients to stay in the hospital for at least 48 hours after a radical mastectomy, and at least 24 hours after a total mastectomy. The bill also requires health plans to pay for reconstructive surgery.

The flurry of reconstructive surgery bill signings may be a fluke, according to Jeff Gabardi, senior vice president for state affairs at the Health Insurance Association of America, Washington.

States are enacting the breast reconstruction laws mainly to bring their statutes into compliance with the federal Womens Health and Cancer Rights Act of 1998, which requires group health plans and individual policies to offer post-mastectomy reconstruction benefits, according to the American Society of Plastic Surgeons, Arlington Heights, Ill.

Some new state laws also require minimum hospital stays following a mastectomy.

For the most part, though, state legislatures are easing up on efforts to add mandates, Gabardi says.

“I think the number of mandates has decreased slightly over the past two years,” he says. “I think this year more than last.”

At least four state legislatures have set up systems for evaluating the cost of proposed mandates, and eight are developing review systems, Gabardi adds.

Although the three governors who signed the new mastectomy mandate bills are Democrats, Gabardi argues against viewing mandates as a partisan issue. “I dont really see any difference between Democratic and Republican inclinations on mandates.”

HIAA declines to take positions on the value of mastectomy mandates or other specific mandates.

Gabardi says HIAA simply tries to drive home the point that mandates can drive up the cost of health insurance and price the poorest purchasers out of the market.

Reproduced from National Underwriter Life & Health/Financial Services Edition, May 13, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


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