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Dynamic Chiropractic – February 15, 1991, Vol. 09, Issue 04

Insurance Equality Eliminated As "No Frills/Barebones" Laws Sweep Nation

By Cheryl Bassitt
The lobbying efforts of small groups and insurance companies have had an impact in many states as they work to eliminate a state's insurance equality laws under the guise of "no frills" or "barebone" insurance statutes. These statutes purport to save thousands in health care insurance dollars by allowing insurance companies to offer health care coverage to small businesses which do not contain so-called "mandated" benefits. In essence, the passage of a "no frills" stature eliminates a state's insurance equality law since most large companies are governed by the federal Employee Retirement Income Security Act (ERISA) programs.

Thus far, Virginia and Washington have passed similar laws which exclude chiropractic. A "no frills" Florida statute includes chiropractic, after chiropractic supporters were able to argue forcefully that providers who offer services are not "mandated benefits."

these proposed statutes, each state needs a cohesive political strategy which includes a strong motivated membership and patients who will offer their support.

The following position statement was modeled after a draft by the American Chiropractic Association (ACA) and then altered to fit the needs of Ohio. State associations are invited to modify it as appropriate.

 

Position Paper of the Ohio State Chiropractic Association

There is currently underway a national effort by certain vested interests in the insurance industry, and by other entities such as the United States Chamber of Commerce and its local chambers, to repeal or to modify so-called "state-mandated" insurance benefits. Inaccurate information has been provided to decision-makers in an attempt to influence them to support these efforts on a local level.

The insurance industry has argued that laws which mandate the inclusion in insurance policies of certain health care conditions are "add-on conditions" which cost additional health care dollars, and that these costs are especially onerous to small businesses. This simplistic approach to the rise in health care costs is totally misleading.

To understand the confusion created by this tactic, one must examine the difference between an add-on condition and a displacement condition. A condition is an add-on when the legislature mandates that a policy of insurance must include a certain condition that is not ordinarily covered in a basic health insurance policy. Additional costs are obviously incurred under this legislative mandate. Displacement conditions are those which do not cost additional monies because the condition is already covered in the basic health insurance policy, and an alternative provider is providing treatment for that condition.

Examples of add-on conditions include mental health, drug dependency, and alcoholism -- all of which are not covered in a basic health insurance policy. Examples of displacement conditions include conditions already covered by the basic plan involving the foot, eye, and back which can be treated by medical doctors, doctors of podiatry, doctors of optometry, or chiropractic physicians.

The vehicle for preventing insurance companies from discriminating against chiropractic care, as well as other alternative health care providers, is a state's insurance equality laws. The insurance industry has attempted to portray these state insurance equality laws as mandating benefits; this portrayal is deceptive.

The simple intent of an insurance equality laws is to allow the consumer freedom to choose the health care provider of his choice, once the insurance company determines if it will cover the patient's condition.

For instance, a basic insurance policy ordinarily covers "back care." State insurance equality laws will guarantee that the consumer has the right to select a medical or chiropractic doctor to treat a back problem. If the insurance company wishes to delete the treatment of a back condition from its policy, it has the right to do so. But once it makes the decision to include the treatment of the condition, state insurance equality laws -- not a mandated benefit law -- guarantee the right of the consumer to select the health care provider of his choice to treat that condition.

Simply stated, state insurance equality laws mandate non- discrimination among health care providers. These laws mandate that no state authorized provider group will have a privileged economic position -- a competitive advantage -- over another class of providers.

It is fundamental that competition among health care providers offers the consumer a benefit in lower costs for health care services. Insurance equality laws foster that principle. These laws do nothing more than mandate competition and a responsible choice for health care providers for the patient.

Cheryl Bassitt
Executive Director,
Ohio State Chiropractic Association
Columbus, Ohio


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