Health insurance requirements considered in Legislature

Insulin costs would be capped, and insurance policies would have to cover more screenings for breast and colorectal cancer, under a proposal being considered in the Nebraska Legislature.

In the Nebraska Legislature, when a bill is amended to include lots of other bills, the result is what is referred to as a “Christmas tree,” referring to all the ornaments attached to one proposal. In the Legislature these days, with the number of bills being limited by filibustering, there’s a whole forest of Christmas trees being cultivated.

That was the case again Tuesday, as a package of bills from the Banking, Commerce and Insurance Committee was being debate. Committee chair Sen. Julie Slama commented on the 15 bills in the package.

“This is really a bill where everybody should be able to find something they like in it, and it represents a wonderful grouping of bills, and I'm so grateful to Speaker Arch for allowing us to put this Christmas tree together to make sure that these low-controversy bills can get across the finish line this year,” Slama said.

Included in the package are proposals by Sen. Elliot Bostar to cap insulin costs at $35 for a 30-day supply, and to require state-regulated insurance policies to cover screening for breast cancer. The bill specifies coverage of more frequent screening for women deemed at high risk by national guidelines. It also requires coverage of screenings for colorectal cancer at no cost to the patient. Bostar said the requirements would save money both for individuals, and society as a whole.

“The costs associated with treating someone with cancer is extraordinary. If you catch it through screenings –prevention -- health care costs a lot less. This is common sense,” Bostar said.

Sen. Ben Hansen, chair of the Health and Human Services Committee, questioned Bostar’s argument.

“What's the long term cost of bills such as this in the long term? And will that cost us more? I have a feeling this will. I mean, I don't think this is going to decrease insurance cost rates. I don't see how it can, because eventually, if you think about free market economics, the insurance companies are probably eventually just gonna increase the rates to pay for this,” Hansen said.

Sen. Merv Riepe expressed philosophical reservations, saying promoting preventative care should be the responsibility of the private sector, not mandated by government.

“Being a conservative, as such, I do have concerns with this ever-growing position of the state of Nebraska trying to become a healthcare dictator, if you will,” Riepe said.

Slama pushed back against that criticism.

“I think I hate mandates more than anybody on this floor. If anybody wants to go to the mat with me on that, I'm willing to go there. So I didn't take adding Senator Bostar’s pieces to this Christmas tree lightly,” she said.

Slama said insurance companies didn’t object to the insulin cap. She said colorectal screening coverage would benefit rural residents who live far away from where they could get a colonoscopy. And she said covering breast cancer screening would help women who currently can’t afford the tests and so undergo mastectomies instead.

Another ornament added to the Christmas tree was a proposal by Sen. Mike McDonnell to try and attract a semiconductor chip manufacturer to Nebraska. McDonnell said it represents a good opportunity to recruit an industry that’s not currently in the state.

“If these companies do not come here, we spend nothing. If these companies do come here and they set up shop here and they start hiring our people and we start training our people through community college and the university, we have actually given the next generation a clear path for success that they don't have as of today,” McDonnell said.

Sen. Megan Hunt opposed McDonnell’s amendment.

“I came by my opposition to Senator MacDonald's amendment honestly. For one thing, I think it has problems from a single subject perspective. But I am also just against what it does, frankly, and the way it could impact our general fund,” Hunt said.

The Nebraska constitution requires bills to contain no more than one subject, although courts have generally given legislatures wide discretion on how they conduct their business.

The Legislature also has a rule that amendments on subjects different from what’s under consideration are not allowed. But enforcing that requires someone to challenge an amendment as not germane, which no one did on McDonnell’s amendment.

Hunt said her concern about the impact on the general fund comes from requirements including a state match for any federal grants to a chip manufacturer, up to 25 percent of the total project cost.

Senators voted 41-1, with only Hunt opposed, to adopt McDonnell’s amendment. And while she and Sen. Machaela Cavanaugh continued their efforts to slow legislative action to protest a proposal to limit health care for transgender youth, the Legislature appeared poised to drape Tuesday’s Christmas tree with a garland of green lights, signifying ‘yes’ votes, later in the evening.