HB 232 -- INSURANCE COVERAGE FOR CANCER SCREENING (Dougherty)

The bill requires health insurers and similar entities to cover
annual pelvic exams and pap smears for nonsymptomatic women,
annual prostate exams for nonsymptomatic men, and annual
colorectal cancer exams.  The coverage is not subject to
deductible limits but patients will be responsible for a
copayment not to exceed $25, if required with the office visit
as part of the insurance plan.

Limited benefit health insurance policies are excluded from the
provisions of this bill.

FISCAL NOTE:  Estimated Cost to All Funds* is Unknown for FY
1998, FY 1999, and FY 2000.  *The combined range of costs for
the Highway Department and Consolidated Health Care Plans is $0
to $3,352,781 for FY 1998; $0 to $3,576,932 for FY 1999; and $0
to $3,186,140 for FY 2000.  Costs are expected to be
substantially less than the upper end of the ranges.  Estimated
Net Income to Insurance Dedicated Fund of $14,250 to $28,500 for
FY 1998, $0 for FY 1999 and FY 2000.

HB 232, HCA 1 -- INSURANCE FOR CANCER SCREENING

SPONSOR:  Dougherty

COMMITTEE ACTION:  Voted "do pass" by the Committee on Public
Health & Safety by a vote of 13 to 2.

The bill requires health insurers and similar entities to cover
annual pelvic exams and pap smears for nonsymptomatic women,
annual prostate exams for nonsymptomatic men, and annual
colorectal cancer exams. The coverage is not subject to
deductible and copayment limits.

HCA 1 -- Requires that there be no deductible for these cancer
screenings.  The patient will be responsible for a copayment not
to exceed $25, if required with the office visit as part of the
insurance plan.

FISCAL NOTE:  Estimated Net Effect on All Funds is unknown.  The
combined range of costs for the Highway Department and
Consolidated Health Care Plans is $0 to $3,352,781 for FY 1998;
$0 to $3,576,932 for FY 1999; and $0 to $3,186,140 for FY 2000.
Costs are expected to be substantially less than the upper end
of the ranges.  Estimated Net Increase to Insurance Dedicated
Fund of $14,250 to $28,500 for FY 1998; $0 for FY 1999; and $0
for FY 2000.

PROPONENTS:  Supporters say that the earlier cancer is detected
and treated, the greater the cost savings realized. Women have
experienced a 75% decrease in cancer mortality due to pap
smears. Insurance companies would spend less if cancer is
detected early. Over 12,000 deaths will occur this year that
could have been prevented through early detection. About 890
people will die of prostate cancer and over 1,000 colon cancer
deaths will occur that could have been prevented through early
detection. This bill will cover about 40% of the people in the
state. ERISA covers the rest.

Testifying for the bill were Representative Dougherty; American
Cancer Society; American Association of Retired Persons;
American Association of Osteopaths and Surgeons; and Missouri
State Medical Association.

OPPONENTS:  Those who oppose the bill say that mandates will
increase the cost of insurance. This would channel people to the
self-funded market. No other states mandate coverage without a
co-pay or deductible. The marketplace should function freely.
Cafeteria plans are an alternative.  Savings realized by early
detection are an unknown factor. The increased costs would be
reflected in the cost of the premiums. Individuals and employers
may be precluded from purchasing insurance because it would
become unaffordable resulting in more uninsured persons. All
testing procedures are not recommended until certain ages.  All
testing procedures are not recommended annually or until one
becomes symptomatic.

Testifying against the bill were Blue Cross/Blue Shield of
Missouri; General American Life Insurance; and Associated
Industries.

Harolyn Light, Research Analyst

HB 232 -- Insurance Coverage for Cancer Screening

Sponsor:  Dougherty

The bill requires health insurers and similar entities to cover
annual pelvic exams and pap smears for nonsymptomatic women,
annual prostate exams for nonsymptomatic men, and annual
colorectal cancer exams. The coverage is not subject to
deductible and copayment limits.