TRENTON, N.J.-There's a bill in the New Jersey Legislature requiring health insurance companies to cover the costs of medical programs to fight obesity
There's one mandating that health insurers cover programs to treat alcoholism, drug addiction, and depression
There are bills that would require health insurers to pay for wigs and hair pieces to make up for the loss of hair through chemotherapy
Other bills would require health insurers to pay for the costs of pap smears, the treatment of sickle cell anemia, replacement dentures, HIV vaccines, and various tests not now covered in standard health insurance policies
These special proposals to have government dictate the coverages are part of a behind the scenes struggle between the health insurance industry and lawmakers about coverage
For the most part the battle pits emotion against costs
On one side is the lawmaker who may feel that the company shouldn't pay for the surgery on a 5-year-old because he wasn't covered under the policy. But that lawmaker will vote for the child every time
Health insurers argue that paying for surgery not included in a policy is the very reason that medical costs are soaring out of control. They lose because a statistical chart hasn't a chance next to a five year old's smile
The issue of mandated coverages resurfaced with the recent signing of a bill requiring insurance companies to pay for the costs of ''medically necessary'' hearing aids for children under age15
The new law requires the insurer to pay up to $1,000 per hearing aid every two years. The cost to the state for children in the state insurance programs is put at $300,000 a year
The new law signed is called "Grace's Law", named for 9-year-old Grace Gelba of Hackettstown,New Jersey
She was born with a congenital hearing loss
Grace and her mother, Jeanine spent seven years to get the law, contacting legislators, writing letters to newspapers and getting her school mates to write elected officials
Grace even appeared before the State Senate Insurance Committee, telling them the "insurance" didn't pay for her hearing aids that had to be replaced every two years
Despite the increased costs emotion won out. There were only 3 votes against it
The other 117 legislators voted for it
Governor Jon Corzine had expressed a "general concern with bills that mandate specific insurance coverage." The written comment was about bill he signed into law a year ago requiring health insurers to pay for prosthetic appliances
He said special insurance coverage bills "deal piecemeal with issues of cost and coverage that might be addressed more comprehensively.'' The Governor said that mandated coverages could limit the ability of the insurer to negotiate price reductions
Grace's law was signed by acting Governor Richard Codey because Corzine was in Washington, D.C. [IA] The workers' compensation rates of New Jersey for the New Year will drop one percent, the first decrease in rates in eight years. Grover Czech, executive director of the Compensation Rating and inspection Bureau said the employers will spend $33 million less for premiums in 2009 than they did in 2008 as a result of the decrease.He said the decrease occurred because of the reduction in claims.' Czech said between 1990 and 2005, injury claims have dropped 88,000
Insurers paid $1.9 billion for the coverage, but paid out $1.3 billion according to the bureau. The rates had increased by 36 percent from 2001 through 2008 largely because of the sharp increases in medical costs, Czech reported. [IA]
