Committee Approves Blues Merger Oversight Bill

HB 1150 also addresses coverage for autism, colorectal cancer screening

The Senate Banking and Insurance Committee today approved a bill to provide state oversight of proposed mergers involving non-profit health insurance companies and to require insurance companies to provide coverage for autism services and colorectal cancer screening, according to Committee Chairman Senator Don White (R-41).

House Bill 1150, as amended in the Committee, would ensure the state has regulatory authority over the proposed merger of Highmark and Independence Blue Cross, the two largest health care insurance companies in the Commonwealth. The bill also would require insurers to provide coverage of autism services and colorectal cancer screenings.

"These three issues have been considered at length by the committee and its members in the course of several public hearings and in meetings with interested groups and individuals," Senator White said. "This has been a very long and complex process, but I believe we are moving toward a consensus on a package that addresses the concerns of the legislature and the administration while providing basic safeguards and vital services for the people of Pennsylvania."

A key provision in HB 1150 is a requirement that any merger involving the "Blues" be subject to approval by the Department of Insurance. While the Insurance Department would hold final approval -- or denial -- authority for a merger of non-profit health insurance companies, the bill empowers the Senate Banking and Insurance Committee and the House Insurance Committee to receive and review all filings submitted to the Department and to develop written comments and recommendations on the merger filings.

"Anyone who has followed the proceedings of this Committee is well aware of our concerns about ensuring that this merger be thoroughly and extensively monitored by the appropriate state governmental entities to protect the rights of health care practitioners and the people of Pennsylvania who rely on those services," Senator White said. "We have a basic responsibility to ensure that any such merger not result in a monopolized market that degrades the accessibility and affordability of health care in Pennsylvania."

The Banking and Insurance Committee held a public hearing on April 1 to hear testimony on the proposed coverage for autism services and a public hearing on May 13 to consider the colorectal screening proposal.

Coverage for autism services would begin one year after the bill is signed into law and be capped at $36,000 per year. The cap would be adjusted on an annual basis based on the rate of inflation. Coverage would be required for businesses having 51 or more employees, a standard used by Florida, South Carolina and other states that require coverage. Companies with 50 or less employees would not be required, but could voluntarily purchase coverage.

In response to a request from Senator White, the Pennsylvania Health Care Cost Containment Council recently conducted a study of insurance coverage for autism services and its potential impact on consumers. In its recently released study, the PHCCCC determined the proposal would result in a modest cost to the average policyholder for coverage to be available for autism services.

"This legislation is intended to strike a reasonable balance between providing service while considering the cost of health care and how it affects small businesses," Senator White said. "Advocates for those who will benefit from this coverage have indicated to this Committee that these services will save lives through the early detection of colorectal cancer and significantly improve the quality of life of families of autistic children. The PHC4 report and public hearings we held earlier this year have made it clear Pennsylvania should move forward on those fronts."

Contact:

Joe Pittman
(717) 787-8724 or cell (724) 541-0552