HOUSE BILL REPORT

HB 1722

BYRepresentatives Ferguson, Dellwo, Bristow, Miller, Moyer and Lux

Providing for insurance coverage for habilitative and rehabilitative services for dependent children.

House Committe on Financial Institutions & Insurance

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (14)

      Signed by Representatives Lux, Chair; Zellinsky, Vice Chair; Anderson, Betrozoff, Chandler, Crane, Day, Dellwo, Dorn, Ferguson, P. King, Nutley, Silver and Winsley.

House Staff:John Conniff (786-7119)

AS REPORTED BY COMMITTEE ON FINANCIAL INSTITUTIONS & INSURANCE

FEBRUARY 3, 1988

BACKGROUND:

Health insurance policies, health care contracts, and health maintenance agreements that provide coverage for dependent children are required by law to provide coverage for newborn infants from and after the moment of birth.  This coverage must include health care benefits for any congenital anomalies of infants.

SUMMARY:

SUBSTITUTE BILL:  The Commissioner is required to create a committee comprised of insurers and certain affected consumers to study coverage for congenital anomalies and make recommendations to the legislature before the next legislative session.  If the committee recommends that insurers provide a particular coverage, the State Health Coordinating Council must review this proposal.

SUBSTITUTE BILL COMPARED TO ORIGINAL: Rather than mandate coverage for rehabilitative and habilitative medical services, the Commissioner is directed to study and recommend changes to the statute governing such coverage.

Fiscal Note:      Not Requested.

House Committee ‑ Testified For:    Paul Richie, Director Early Childhood Development Association; Charlene Monuszo, Parent and Judith Moore, Early Childhood Development Association of Washington.

House Committee - Testified Against:      Joan Gaumer, Blue Cross; Mel Sorenson, Washington Physicians Service and Basil Badley, Health Insurers Association of America.

House Committee - Testimony For:    The statute for governing health coverage for treatment of congenital anomalies of newborns was intended to extend to coverage for habilitative and rehabilitative services.  Health insurers have slowly eroded this statutory coverage and should be specifically required to provide coverage for habilitative and rehabilitative services.

House Committee - Testimony Against:      The statute does not require full coverage of rehabilitative and habilitative services.  The legislature should not mandate health coverages.  If coverage is to be mandated, the State Health Coordinating council should review the mandate.  Requiring coverage for full rehabilitative and full habilitative services would substantially increase insurance premiums.