House OKs coverage for prosthetics

Lawmakers surprisingly overcame their usual phobia of medical insurance mandates as the House voted 46-27 Friday in favor of a bill that would put prosthetics for amputees on par with hip and knee replacements in some medical insurance plans.

Mandates might be wrong, but it's worse not to approve a basic benefit that will keep at least 5,000 people literally up and around for just a few pennies on the insurance premium dollar, lawmakers said in explaining why they were making an exception.

Lawmakers across the hall seemed to be in a mandate-light mood. Senators amended, approved 21-4 then sent to the house SB43, a bill that in effect would require insurance carriers to offer in-home therapy for a variety of autism disorders as part of their coverage packages.

The amendments softened language in the original bill, which was approved last week 17-11. A requirement to "provide" therapy was changed to "offer" treatment, and added language prohibiting discrimination against a person who has an autistic disorder under the state's accident and health insurance code.

Rep. Lorie Fowlke, R-Orem, said she is going against her own and her fellow Utah County legislators on HB89 because her constituents wanted the exception and "for the very reason our system is not working the way it should."

"I'm for market-driven health care, but the market is never going to address this," she said, noting that doing so would be too much to expect from insurance plans "that still will cover Viagra but not birth control."

Rep. Francis Gibson, R-Mapleton, said that he understands, as a health care service provider and as a lawmaker, the fear of mandating coverage for anything. "This is just doing the right thing for a population that is productive, that wants to stay that way, and we can do this at the lowest possible funding."

House Minority Leader David Litvack, D-Salt Lake, said that while it is one of those "M-word bills, the evil mandate," the requirements will actually cost shift about 12 cents per month to people's insurance premiums, but it will save hundreds of thousands almost immediately, he said. The proof is in Colorado, which has saved nearly a million dollars in just the past two years because people have been able to continue working.

Rep. Steve Mascaro, R-West Jordan, seemed to sway any fence-sitters on the matter by describing what he called the inherent unfairness of an insurance industry that will pay hundreds of thousands for hip, knee, shoulder and other joint replacements, yet won't pay for prosthetics that give people close to their normal mobility.