House passes health care legislation

Several consumer friendly bills have passed the House and are on their way to the Senate for passage this session. Everyone concerned about health care costs will agree with HB263 by Rep. Cary Smith (R-Billings). It is an act requiring certain health care providers and facilities to disclose estimated costs of treatment.

The details of the bill require providers to give the estimate at the time the service is scheduled or within 10 business days of the patient’s or agent’s request. Though it won’t bring the cost of a procedure down it will make the patient aware of the costs before it’s done. At least the patient will be allowed upfront knowledge and make decisions based on a known cost.

HB264, another by Rep. Smith, will require health insurers to disclose preapproval requirements and estimated covered and out-of-pocket costs for services. This may introduce competition in the marketplace and allow more answers to questions we usually ask ourselves only after our doctor bills come in the mail.

Montana voters were much in favor of the CHIPS program on the November ballot. The Children’s Health Insurance Plan has been a big push by Sen. Baucus on the national level, too. He was here last week talking with a joint session of the Legislature and urged us to pass the funding for it.

The 2007 Legislature didn’t vote for similar legislation on the following grounds: a) it removed 1/3 of the state tax on health care insurance from the general fund and placed it in a special revenue account, b) money could be used to cover uninsureds, pay administrative costs and educate enrollment partners, and c) allowed the Department of Health and Human Services, a state agency, to change the requirements without returning to the Legislature for approval.

The Healthy Montana Kids program allows for a family of four to have an income up to $63,600 a year (250 percent of the federal poverty rate) with no asset test. Several legislators were concerned that this kind of income in Montana is well above the average working family and may encourage families who can afford insurance to leave their children uncovered for three months in another health package in order to take advantage of “free” money from the government’s insurance package.

How many people knew the income levels when they voted in November? It will be interesting how this all shakes out and Montanans begin using it for their children’s primary health care option. One legislator expressed concern that Blue Cross Blue Shield will be the only provider and there would be no more primary care physicians taking new patients than there were before CHIPS passed. Time will tell.

In order to fund this new plan in our current economic situation, programs for the developmentally disabled or seniors will have cuts. I don’t believe this is what the voters intended to happen. An amendment to add more money to the current CHIP program to serve 17,000 more children was offered by the Republicans but was killed by the Democrats in committee. I hope they will reconsider this action so that the intent of the voter can begin, even if it isn’t at 100 percent right now.

The “free” clinic in the Earl Bennett Building in Kalispell is an option for many seeking health services. The charges are calculated on your ability to pay so should fill some needed gaps for those who are uninsured or under insured until the jobs in the Flathead start up again. They now have a dentist in addition to their other medical staff. Continued funding for these clinics across the state is working its way through the session and most believe it’s a good use of our money.

Many of my contacts in the last two weeks have been about the stream access bill and the “castle” doctrine on the right to self protection. House committees will begin hearings on Senate bills next week while they hear our bills which have passed floor discussions. Any bills which have not passed the House or Senate by transmittal this weekend will die in committee unless they are revenue bills.

I look forward to future concerns and can be contacted through the state’s Web site at www.leg.mt.gov or by leaving a message at (406) 444-4800. It’s always good to hear from people in the Flathead.

Rep. Dee Brown, HD 3, is a Republican Whip in the Montana House.