Valdosta Daily Times

November 17, 2013

Insurance committee votes tomorrow

Kay Harris
The Valdosta Daily Times

VALDOSTA — The Special Advisory Commission on Mandated Health Insurance Benefits, created to advise Gov. Nathan Deal and the General Assembly on several proposed mandated benefits, will vote tomorrow in Atlanta after a year of meetings and research into the issues.

Two Valdosta residents were appointed to the committee in January by Gov. Deal —  Steven M. Wilson, O.D., and Myron Faircloth, DNP.

As chairman of the Insurance and Labor Committee in the Georgia State Senate, Sen. Tim Golden was instrumental in the formation of the committee.

“We wanted to pull together people outside of politics who are familiar with all aspects of the potential financial, social and efficacy impacts of these mandates,” said Golden.

The committee has been studying three primary medical issues, all of which are the focus of bills introduced in the legislature — Ava’s Law, which is concerned with certain treatments for autism; Hearing Aid coverage for children; and the Medical Food Equity Act, which would allow special foods to be prescribed for certain medical conditions.

According to Golden, part of the issues concerning these three proposed mandates is the impact on small business.

“There are so many groups that are exempt from providing the state-mandated health insurance benefits, it’s not fair to small businesses, who are already getting hit hard with the new national health plan,” said Golden. The groups exempt include the State of Georgia, the federal government and self-insured businesses.

“These mandates have the potential to drive costs through the roof for small businesses. I’m not sure how much more they can handle,” said Golden.

The bills were tabled in the 2013 legislative session, pending the Nov. 18 vote and recommendations made by the Special Advisory Commission, which are non-binding but “will have an impact” on how legislators vote in the 2014 session.

“Our job is to take the emotional aspect of these issues and balance them with the financial and social impacts. There are strong lobbyists on each issue who have made presentations to the committee. We’re human; it affects you,” said Faircloth.

“You want to be able to say everything should be covered, but you can’t.”

Faircloth is serving on the committee studying the social impacts of the mandates while Wilson is serving on the financial committee.

“Heath insurance is on the forefront of the national agenda right now. It’s exciting to be part of the process,” said Wilson.

Golden said he appreciates their assistance and points out that their service is voluntary with no compensation or per diem.

Following is a summary of the issues the Commission members will vote on Monday:

• Ava’s Law would require insurance plans subject to legislative mandates to pay for specific treatments and behavioral health programs not typically covered for children diagnosed with autism spectrum disorders.

• Hearing Aid Coverage for Children Act would require health plans to provide coverage for hearing aids for children, including cost of related services and the frequency of replacements.

• The Medical Food Equity Act would require insurance coverage for physician prescribed special dietary foods or formulas for specific chronic medical conditions, including food tolerance and absorption disorders.