Legislature poised to limit access to mammograms, prostate screenings, immunizations & more

While the new federal health law has expanded consumer guarantees for minimum health benefits, Oklahoma is poised to move in the opposite direction. Embedded in an ‘interstate compact’ bill to allow out-of-state insurers to sell policies in Oklahoma is a provision that could nullify several of the state’s existing consumer protections. Language in SB 1059 appears to exempt both out-of-state and in-state insurers from state laws regarding minimum coverage and benefits offered by health insurance policies.  This bill would turn back the clock on our health care system and deprive Oklahomans of essential medical care that they rely on their insurance to provide.

SB 1059 would allow the Oklahoma Insurance Department to enter into agreements with one or more states to allow the sale of insurance across state lines.  The bill also exempts these out-of-state insurers from the minimum benefits that Oklahomans are entitled to under existing state law.  Oklahoma requires insurance companies to cover a handful of basic benefits. These benefits, or ‘mandates’, ensure that health insurance plans cover essential health services. The state’s mandated benefits cover preventive health services for children (immunizations), women (mammography and bone density screenings, maternity care, and annual pelvic exams and cervical cancer screenings), and those with chronic conditions (diabetes supplies, mental health treatment).

Proponents of the legislation are quick to point out that exempting insurers from minimum coverage requirements is not the intent of the bill; the purpose of exempting in-state insurers from covering basic benefits is to allow them to compete with new out-of-state plans that will flow in after we’ve signed a compact with another state.  For instance, if Texas insurers are allowed to sell so-called ‘skeleton’ coverage in Oklahoma, without including basic benefits like child immunizations or colonoscopies, than Oklahoma insurers should be allowed to offer such plans too.  Regardless of the intent of the bill, if SB 1059 becomes law it effectively suspends minimum benefit requirements for any insurer in the state that wants to mimic a ‘skeleton’ plan sold by an out-of-state competitor.

For households of modest means, paying out-of-pocket for cancer screenings and immunizations represents a significant cost burden, and many families will have to go without some of these critical services.  Not to mention the symbolic indifference of exempting insurers from covering the costs of, for instance, wigs or hairpieces to extend a little basic human dignity to Oklahoman’s undergoing radiation and chemotherapy treatments.  Oklahoma insurers cleared $25 million in after-tax profit in a single year in the individual market alone, which doesn’t even include profits made off the large group market, where most Oklahomans get their health insurance.

This bill has already passed the state House and Senate and will move next to a conference committee.  If changes are made in conference, it must be approved by both the House and Senate again before heading to Governor Fallin for final approval.  To voice your opinion about SB 1059, click here to enter your address and find your state House and Senate members’ contact information.