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January 03, 2010 07:54 AM UTC

A Very Nasty Bill, Indeed

  • 36 Comments
  • by: Colorado Pols

The Colorado Independent followed up Thursday on a piece of legislation we discussed a few days ago in relation to the recent disaffiliation of Rep. Kathleen Curry from the Democratic Party. To briefly recap, we described the bill as “crafted by the insurance industry,” seeking a moratorium on new health coverage mandates of the kind that have passed in recent years and expected this coming session–and asserted that Curry’s sponsorship of the bill may have played a role in her party change, a switch that appears erratic and ill-planned as she must now mount a difficult write-in campaign for re-election. We note that the bill’s role in her switch has been “adamantly” downplayed by Rep. Curry, but the details of said legislation have got to make you wonder.

For one thing, it is absolutely “crafted by the insurance industry.” And nasty.

A proposed bill that would institute a one-year moratorium on insurance mandates aims to wipe out a number of measures slated for next session, including legislation that would require Colorado insurance companies to cover maternity care and birth control.

The moratorium is being proposed by the Colorado State Association of Health Underwriters (CSAHU), according to CSAHU lobbyist Cindy Sovine-Miller. Although the health insurance industry group is still working to land Senate sponsors, Sovine-Miller said she expects Ellen Roberts, a Durango Republican, and Kathleen Curry, a Western Slope Democrat-turned-Independent to carry the bill in the House…

Sovine-Miller said she expected the bill to come early in the session, presumably to head off any mandate bills legislators intend to introduce. [Pols emphasis]

“This bill is probably going to come right out of the gate. We really want to set the tone for the session,” she said.

According to Sovine-Miller, the bill aims to point out that requiring insurance companies to cover different health care needs unfairly puts “unfunded mandates” on small businesses instead of turning to other available resources to provide health services…

“Autism is not a physical body need,” she said. “It’s not even necessarily a mental-health need. It’s a whole range of things that require various physical therapies and health care therapies… Because the state education system can’t afford it, they’re pushing it off to the people who can.”

So if “setting the tone for the session” means preemptively chopping off a bunch of other legislators’ bills at the knees, then yes, you might find this ‘moratorium’ an acceptable bill for the House speaker pro tempore to sponsor. The rest of you should be able to understand easily why it raised eyebrows. We know about the other considerations that allegedly played into her decision, her contrary vote on Arveschoug-Bird and a few other bills. Those were well-known disagreements, but what Curry is trying to downplay–this belligerent legislation she’s going to sponsor with the GOP’s #1 Senate pickup hopeful–is a bigger part of this odd story than either she or the Colorado State Association of Health Underwriters would prefer to get into right now.

At the very least, we think Ellen Roberts’ strained description of “a good bill, and a bipartisan bill” to the Colorado Statesman is in need of two factual revisions.

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36 thoughts on “A Very Nasty Bill, Indeed”

    1. If that kind of shit gets out into the common knowledge it will make everyone associated with this bill look very bad.

      Note to Bruce Whitehead.

  2. Amendment 51 in 2008.  They don’t seem to want those families with autistic children or children with disabilities from getting any help.  The Dem leadership needs to remove Curry from any positions that she holds and boot her out of the caucus.  What a nasty insurance company flunky.

    1. She’s already done that to herself, they’d have to invite her in from my understanding, so all they have to do is just leave her be as an (i)….   I think this means she could potentially not be on any committees if she doesn’t caucus with either…  

      Personally I was tired of her BS, let her go and try to mount a write-in campaign for re-election… Not gonna happen, especially not with any party supporting her and in such a dem-leaning seat!

  3. It’s a one year moratorium, and with all the federal mandates coming down the pike, maybe it’s not a bad idea to hold off on state mandates. I’d love to pay $100 a month and have the insurance company cover 100% of my medical expenses, including a little lypo for my holiday indulgences. I can understand disagreements over the merits of the bill, but I don’t see the support of it as “nasty” or “belligerent”.  

    3. Well, I guess if the bill targeted any of the horribles you propose, you might have a point.  But it doesn’t, and it apparently specifically targets medical care for autistic children.

      Studies indicate that the best outcomes for treating autism come from early intervention.  So delaying treatment, even for a year, can be disastrous.

      So yes, it is nasty to single out young children in need of treatment.  And, its also nasty to lie and misrepresent what a bill would do.

      1. The bill can and will receive amendments presented in committee (if not rewritten as a compromise before it’s assigned). If citizens are concerned enough to voice their opinion on such critical issues as autistic children (and you can count me among them) the members are more likely to be moved before and during the hearing process. Admittedly the makeup of the committee can’t be discounted or the fact that’s it’s an election year.

        Ellen Roberts is on Health and Human Services Committee but as an R that doesn’t mean it will see the light of day on the floor of the House if the D’s decide to kill it or it’s PI’d.

      2. then I could agree.  But if the bill is a response to the education system’s desire to shift their mandates, then I can see why the insurance industry would want the moratorium.  I don’t know Roberts, but I know Curry well enough to know she didn’t wake up one morning and say “How can I hurt Autistic children today?” It can’t be for political gain either, since she’s pretty much given up her power, and possibly her seat.    

        1. A state law cannot prevail over the federal requirement that children with disabilities receive a free and appropriate education.  Please inform yourself better on the difference between providing an education and providing medical care.

          Legislation should be judged by its effects, not whether you believe a particular legislator is pure of heart.  If Curry is carrying water for the insurance industry so that they can evade the responsibility of providing medical care to autistic children, then she is seeking to destroy children’s lives–and I think “nasty” is one of the milder adjectives I would attach to her and her bill.

          And its “lipo” as in “liposuction,” not lypo.

          1. about the fact that the IDEA pre-empts any state law, that does not mean that Lauren is necessarily wrong about the possibility of transfering some of the unfunded mandate to insurance companies: If insurance companies are required to pay certain costs associated with treatment necessary to receiving a FAPE, then the schools are relieved of those costs, without any state law having defied the federal law.

            Having said that, just to be clear, I disagree with Lauren’s overall position: I agree with Pols that this is nasty bill.

            1. I don’t think that IDEA guarantees a FAPE only to the extent that a child is not otherwise receiving services.  The fact that a parent provides or pays for outside services (whether out of pocket or reimbursed) does not relieve a school district of its obligations under IDEA.

              Furthermore, if services are required under IDEA, an insurer might be able to seek reimbursement under a subrogation theory.

              1. If a parent pays for services that they believe the school was required to provide under IDEA, and can prove in court that the school was indeed required to provide the services and failed to, then, under certain circumstances, they can recover the costs. But that is because the parents are specifically being protected by the law, not because all other potential bearers of some of that burden are being protected.

                But if a state law increases the coverage required of insurance companies in ways which incidentally provides services which schools would otherwise be required to provide under IDEA, then the school would certainly not be required to duplicate the services unnecessarily, nor, in my opinion, to reimburse the insurance company, thus effectively relieving them of the burden.

                I suppose you could try the subrogation argument, but I donВґt believe that it would prevail. The IDEA mandate applies, basically, to whatever is currently lacking that is needed to provide a student with a FAPE. For instance, I doubt that schools are required to pay the costs of medications (let’s say to control seizures) currently covered by the child’s health insurer (thus relieving the insurer of the responsibility they would otherwise have borne), whose use is required by the child in order to receive a FAPE. The school would only be required to make accomodations necessary under the conditions that the child comes to school, conditions which might vary under differing insurance regimes.

                As an aside, I have no problem whatsoever with transferring some of these costs to insurance companies: They are a burden on schools which often dramatically reduce the resources available for the education of other students.

                1. Under IDEA, services are required to be provided by the school regardless of whether the services are available elsewhere.  That would likely trump a state law that required insurance to pay for the services.  Essentially, the school is the provider of first, not last, resort–which is as it should be since, at heart, IDEA legislatively provides what due process requires.

                  As you point out, there are medical services not covered by IDEA.  Thus, there is already an understanding as to where the line is drawn between medical and educational intervention.

                  Finally, subrogation is a generally applicable principle of equity, and I don’t see why it wouldn’t apply in the case of an insurance company that paid for services that would be required under IDEA.  Of course, expect considerable litigation to determine the extent to which subrogation would apply in such cases.

                  1. whether there is a fixed line between what would be deemed educational and medical interventions. I think the line, such all such lines interpreted through case law, are in constant flux, and constantly negotiated through the articulation of various laws that determine where it is drawn.

                  2. 1) There is absolutely no doubt that requirements imposed on health insurers by state law can affect the burden borne by schools under the IDEA. Schools are required to accommodate students’ needs to the extent required to ensure that they receive a FAPE: If a student is wheelchair bound, or prone to frequent seizures, then the school must provide the necessary services to enable that student to receive a FAPE. Whether health insurers are required to underwrite services outside of the school context which determine whether a child remains or does not remain wheelchair bound, or is or is not prone to seizures, affects the burden borne by the school. The school is not responsible for those medical treatments under the IDEA, only for the accommodations made necessary by their absence. There is no subrogation argument.

                    2) The argument that proposed mandates on insurance companies shift burdens from schools to insurance companies is a bad argument not because no such shifting of burdens can occur (it can; see no. 1 above), but rather because the differing purposes and consequences of responses render the shifting of the burden incidental to the provision of health care and educational services. No state law which requires health insurers to treat any medical needs of children would ever be pre-empted by the IDEA, because the IDEA is a mandate for accommodation, not medical treatment. The reduced burden on schools as a result of improved health care is incidental to the improved health care.

                    The fact that schools are sometimes responsible for facets of the medical care of their disabled students under the IDEA is a residual consequence of the needs of students in the condition that the schools find them, not an imposition on schools of primary responsibility for the treatment of that condition. Neither the plain text of the law, nor legislative intent, nor public policy considerations support any other conclusion.

          2. I didn’t offer facts, I said “if…then”, based upon the explanation given in the original Co Pols post.  My point about Curry, is that there must be something she sees as valuable in this bill, or she wouldn’t co-sponsor it.

            I doubt if it matters anyway.  Does anyone think this bill will get through the House and Senate, and be signed into law by Ritter?  I’d hate to waste all this angst on a non-issue.

        2. No one sets out to hurt autistic kids, but if you let the insurance industry decide that autism isn’t physical body need and it maybe isn’t a mental health need, you are allowing the insurance industry to put profits over people and that is the reality of your action.

          BTW autism IS a physical body need it is a disability embedded in the biochemistry of the brain.

          Besides this is really about pregnancy which I believe the the leg is going to try to get covered and that is a physical body need.  Shame.

        3. write and fill prescriptions?  And apparently in Bacall’s and Sovine-Miller’s world they can perform diagnostic tests and prescribe treatments.

          Sorry, but in the real world that is the pervue of doctors…not teachers.

          I’m not saying that hurting children with autism was the goal of Rep. Curry, but that will be the impact of this bill so, frankly her goal at the outset is of no import, the impact however, is.

    4. You are dead wrong here.  It is clearly an attempt to hold off, with a view toward undoing, at state level everything that the insurers object to in the federal legislation,  It is no doubt part of a state by state rear guard action on the part of the staunch allies of the insurance industry who believe that keeping us all under the thumb of a bloated monopoly cartel is a much higher priority than providing quality health care to the little people.

      At a federal level the GOP has vowed to work for repeal. It all fits together and the idea of Curry retaining anythng approaching a leadership position now in our Dem majority legislature is absurd. Her parsing of the autism issue is positively offensive.    

    5. for my holiday indulgences?  You put that out there as a supposed counterbalance in a discussion about care for autistic children?  And by extension, 50-year-old DD folks on a long waiting list for state services, whose parents are elderly and in poor health?

      Yes, the bill is nasty, as was your comment.  I’d go beyond “belligerent” and describe it as “scorched earth.”  Children and women, take cover.  Heavy artillery coming your way.  

      3. Calm down, dear.  I think you’ve overreacted, and read too much into, Ms. Bacall’s comment.  She did not use “lypo” as a “counterbalance” to denying health care for autistic children.

          1. even those of us with insurance, can’t afford basic health care with our high deductibles, much less have a snowball’s chance in hell of coverage for something frivolous, we perhaps are a bit too grumpy to “get” the humor.  That and the fact that disabled children are inherently not very funny.

            Sorry I wasn’t amused as you imply was your intention.  My bad. Business was so slow this past year, we’ve had to pay our private health insurance premiums on credit some months and certainly can’t afford to actually use it.  I’m still nursing a nasty finger cut that I should have gone to the ER with and it all tends to bring out the  grumpy side of my nature.

  4. that is most bothersome in this bill and it isn’t autism in children.

    It’s the proposed maternity and birth control mandate moratorium for the individual markets that concerns me. This is a mandate that does not cover a woman if she becomes pregnant. Worse, if she is trying to prevent being pregnant because she has no insurance to cover it, this mandates refuses to cover her birth control!

    It’s one of the most anti-woman measures I’ve seen come down the pike in quite some time and it is a direct response to the proposed mandate that Representative Jerry Frangas is sponsoring.

    Even the CSAHU lobbyist admits that it has zero impact on small businesses.

    Sovine-Miller acknowledged that the proposed maternity mandate wouldn’t impact small businesses, since it only mandates maternity coverage on the individual market,…

    And no, this isn’t about abortion for Curry or the health insurance industry because Frangas’s bill explicitly excludes coverage of all abortion procedures and expenses.

    If that isn’t bad enough, the heath insurance lobbyist admits that most of this effort is disingenuous at best because the moratorium would expire long before the federal reforms even take place.

    The moratorium also aims to give insurers a chance to catch up with- and understand the implications of- any federal reform, she said. She acknowledged, however, that the moratorium would expire long before most federal health care reforms are expected to take effect in 2013.

    1. in my comment above:

      Children and women, take cover.  Heavy artillery coming your way.

      No, this particular bill is not likely to see Ritter’s desk.  That mitigates only slightly the scorched earth tone and intent, and the knowledge that more artillery from the Insurance Industry is being teed up every day.

      Instead of making sure the people who’ve paid them for health security actually get it.  

      1. So let me get this straight — Rep. Curry:

        1. Forfeits her D affiliation

        2. Most likely her leadership position

        and seat

        3. Potentially splitting the vote enough to hand it to an R

        4. For a bill that is revoltingly anti-women

        5. Too short in duration to have any effect on it’s advertised intent to impose a moratorium on federal laws scheduled for 3 or 4 years from now

        6. And would be trumped by same federal law anyway

        7. Besides having zero chance of passage

        8. All to let the Insurance lobby “set the tone” of the coming legislative session?

        Forgive my political naivete, but I don’t see any winners here, least of all the insurance lobby or Ms. Curry.

  5. People usually think they are covered until they make a claim, then they find out about the exclusions and limits of their coverage.

    The legislature is just trying to get insurance companies to provide the coverage that the insurance industry advertises they provide.

    Always remember the insurance industry business model is based on maximizing premiums and minimizing benefits.  This is why we have exclusions, preexisting conditions and post claim underwriting used as part of the business model to maximize profits.

    If they said “we take your money and provide no benefits” nobody would buy the product.

  6. I want health insurance that covers everything of consequence and does so with a minimum of bureaucracy & headache. I need my employees concentrating on work, not on how to handle holes in their coverage.

    So, for the sake of small business in this state, please do get us clear mandates that make insurance coverage comprehensive in practice. And if that pushes the price up 10% – well worth it.

    And I say all this from a pure bottom line perspective.

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