New year means new health insurance laws for Connecticut

The beginning of 2012 ushered in seven new requirements for health insurance coverage provided by employers to Connecticut residents that proponents say will save lives and money in the long run.

"An ounce of prevention is worth a pound of cure," said state Sen. Joseph Crisco Jr., D-Woodbridge, co-chairman of the state legislature's Insurance and Real Estate Committee, referring to the new requirements for breast MRIs, colonoscopies and prostate cancer screening and treatment.

The other new requirements pertain to coverage for ostomy supplies, pain medications, clinical trial costs and bone marrow testing.

Opponents predict the new laws will have a negative effect, however, driving up the costs to employers of providing health insurance and ultimately making the state less business-friendly.

"The fact that we have seven new or expanded mandates is pretty daunting," said Eric George, associate council of the Connecticut Business and Industry Association, adding that he expects some employers will drop coverage. "Small employers are already stretched as far as they can go."

About half of the state's employers will be affected by the new requirements, George said. These are the companies that purchase coverage for their employees through private insurers, versus companies that pay the coverage costs themselves and contract with private insurers to administer the plans.

Before the new laws, George said, there were 60 state-mandated requirements for employer health insurance plans. According to the Council for Affordable Health Insurance, a national advocacy group for the insurance industry, these accounted for 25 percent to half of the premium costs in Connecticut.

Crisco said he believes the CBIA's concerns are exaggerated, and that the new requirements will actually save money and lives in the long run by detecting cancers earlier and providing better health care for state residents.

He referred to the one that mandates coverage for breast MRIs for women with dense breast tissue, or who are at increased breast cancer risk due to family history or other factors.

MRIs can detect some cancers that routine ultrasound testing does not, particularly in women with dense tissue. With earlier detection, more of these cancers can be treated earlier and more successfully, he said.

State Rep. Betsy Ritter, D-Waterford, said she believes the new requirements will have a positive effect on health care.

"They are a reflection of robust health care coverage, not punitive an any way," said Ritter, who is co-chairwoman of the legislature's Public Health Committee. "These are simply the right thing to do."

According to a 2011 analysis by the University of Connecticut's Center for Public Health and Health Policy, the breast MRI coverage will add 92 cents per person per month to the cost of health insurance. At least four of the state's largest insurers already cover the test, which can cost about $2,000.

The other new mandates were not included in the UConn analysis, but will be part of an analysis that will be done this year, said Donna Tommelleo, spokeswoman for the state Insurance Department.

Along with the breast MRI coverage, the other new requirements are:

• coverage for compatibility testing for bone marrow transplants for people who sign up for the National Bone Marrow Donor Program.

vcoverage for patient care costs associated with clinical trials for those with disabling or life threatening chronic diseases.

• additional coverage for more than one colonoscopy per year ordered by a physician; and for equivalent pay for physician services for colonoscopies or endoscopies regardless of whether they are performed in a hospital or private office.

• coverage of up to $2,500 annually for ostomy supplies and appliances, up from $1,000.

• elimination of insurers' policies that an insured person use generics or over-the-counter pain medications first when a brand-name pain medication is prescribed by a physician.

• coverage for screening and treatment for prostate cancer.

j.benson@theday.com