Senate vote: no coverage for mammograms

[snappy]

There was a full page ad in my paper today from the American Cancer Society. The ad's purpose is to alert everyone that our illustrious US Senate is about to vote on S 1955. According to the ACS ad, this bill would gut laws in 49 states that require health insurance companies to cover regular mammograms. Coverage of other lifesaving cancer screenings is also at risk. Great, lets go backwards here, you idiots. I guess the insurance companies are making a full court press for passage of this bill.

The ad gives a number: 1-888-NOW-I-CAN (1-888-669-4226). This is a number for the ACS. You call, give your name and address, and they connect you with the office of one of your US senators.

I am furious that I am just finding out about this now. The ad does not specify when the bill will be voted on. I am livid though that the "alert" was not put out much, much earlier. Anyone else see something about this?

My tumor would never have been found without that first screening mammogram. Please everyone, call the number and tell your senator to protect coverage for mammograms.

 

[mickeysgal]

Why, oh why is our government so out of touch with the health care system in this country? Why can't they see that something needs to be done to provide reasonably-priced health care to EVERYONE in this country. The system is broke and so many families are financially drowning because they can't get effective, reasonable, and available heath care.

Our current insurance covered mammograms every other year once you're 40. At 50, its every year. Our prior insurance covered them every year starting at 40. Now, facing a layoff, we'll have Cobra, but so many others can't afford Cobra.

I just don't get it...perhaps enough senator's wives or family members haven't had to experience breast cancer yet or any other health crisis. Then and only then will we see changes. Until then, when they live off taxpayer's salaries and collect their inflated special govn't pensions, nothing will change.

 

[snappy]

Here's what I found on the AARP issues blog website:

home


Unintended Consequences Worth Considering
In early May, the U.S. Senate likely will vote on legislation intended to make health insurance more accessible and affordable for many small businesses across the country. That’s a laudable goal. The problem is that the “Health Insurance Marketplace Modernization and Affordability Act,” or S.1955, could have the unintended consequence of making health insurance less accessible and affordable for many others.

S.1955 would allow businesses affiliated with national trade associations or similar umbrella organizations to form groups, across state lines, in order to buy health insurance. But in doing so, the bill would preempt critical consumer protections, including those relating to rates and benefits, that many states have in place. While the effects will differ from state to state, the already fragile health insurance market could be destabilized everywhere.

Limitations on the use of health status, gender, age, occupation or other such factors in setting rates would be overridden in some states. Services that are widely recognized as essential—and that many states mandate—such as mammograms and other cancer screening, mental health services, diabetes test strips and glucose monitors, maternity and well-baby care, would not have to be covered.

A twenty-something female in New England who has diabetes has blogged about this proposed legislation, asking a simple, and easy-to-understand question. She asks, “So explain to me why the government wants to make it more difficult for me to remain healthy?”

If you have any chronic disease such as diabetes or cancer, you may want to think about this question. Who else should worry? Baby boomers who presently are working should stop and think whether their employer would choose to start charging them more for their health insurance at work because of their age. As our population ages, and labor markets tighten, older workers are becoming increasingly important to the continuing strength of our economy. Regrettably, S.1955 sends the wrong signal about the value of hiring and retaining them. Of all the unintended consequences of this well-meaning legislation, that may prove to be the worst. But, S.1955 also may affect people who rely on mental health services, women of child-bearing age, and young workers who get sick or injured.

As reported in The Hill, AARP opposes S.1955, as do groups such as the American Diabetes Association and the American Cancer Society. Insurance Commissioners in CA, CT, FL, IA, NV, NH, NY, RI, VT, WA and WI have already written to Congress to oppose this bill. An important concern of AARP is that this bill eliminates consumer protections by not requiring insurance carriers to give guaranteed renewability and not requiring small business health plans to follow COBRA continuation rules.


Sounds to me like we all need to worry.

 

[The Mystery Machine]

Wow..thanks for the info. Here is the link for all of you to read. Blows me away, really.
http://www.acscan.org/site/pp.asp?c=cnJHJIPuB&b=83243

edited to add..
I just sent an e-card from this site. It took 1 minute & easy. I hope it means something.

 

[MerryPoppins]

Keeping this bumped up. I sent my email. Please send yours!

 

[wvjules]

I'm sympathetic to the issue however, isn't it up to the individual, privately owned insurance companies to decide what they want to cover and what they don't? Why should it be a law that they have to cover anything?

Also, even if it isn't required it doesn't mean that all, some, or even any of them will drop their coverage for it. Its probably in their best interest to cover preventitive medicine/procedures than it is to not cover them but then have to pay for treatment of the illness.

 

[Miss Jasmine]

I sent my senators emails.

 

[mrsltg]

Ok, against my better judgement, I'll jump in.

1. The title of the thread is ridiculous and meant to arouse emotion. The bill before the Senate is not saying "There will be no coverage for mammograms."

2. So we want more people to be given insurance coverage. Great. Nevermind that businesses are able to use coverage as a benefit to lure a potential employee into their organization over a competing organization. Now not only should the Federal government mandate who should be covered but what should be covered?

3. The 20-something New England female needs a civics lesson. Last I checked the government should not have ANY INTEREST in her health.

Things cost money. Screening tests cost money. Those costs are passed on to the consumer - you and me. Insurance companies aren't stupid. If you become deathly ill it's likely they will pay more on your behalf than you paid in. That's a loosing business proposition. If the population begins a rapid decline that will mean less money as well. Again, common business sense. Believe it or not, insurance companies are in business to MAKE money. They are not there to keep you healthy - that is a nice side-effect though. An actuary sits in a room somewhere and determines how much of a risk you are. Risks go up based on certain behaviors, demographics, environmental factors, etc etc etc. Some people should pay more than others.

Finally, notice the use of scare words in the AARP article. Words like, "can", "may", "might", "have". No where does it say, "If this bill becomes law no one will have access to mammograms or other vital screeing tests." No where does it say, "This will have a negative effect on you and your loved ones." The reason it doesn't say these things is because they are not true. These are all possibilities - of course, a comet plummeting into the Earth is a possibility, too. I hate when political groups do this. "Call Congress today and tell them you are against xxxxxx before it's too late!"

 

[rayelias]

Ok, against my better judgement, I'll jump in.

1. The title of the thread is ridiculous and meant to arouse emotion. The bill before the Senate is not saying "There will be no coverage for mammograms."

2. So we want more people to be given insurance coverage. Great. Nevermind that businesses are able to use coverage as a benefit to lure a potential employee into their organization over a competing organization. Now not only should the Federal government mandate who should be covered but what should be covered?

3. The 20-something New England female needs a civics lesson. Last I checked the government should not have ANY INTEREST in her health.

Things cost money. Screening tests cost money. Those costs are passed on to the consumer - you and me. Insurance companies aren't stupid. If you become deathly ill it's likely they will pay more on your behalf than you paid in. That's a loosing business proposition. If the population begins a rapid decline that will mean less money as well. Again, common business sense. Believe it or not, insurance companies are in business to MAKE money. They are not there to keep you healthy - that is a nice side-effect though. An actuary sits in a room somewhere and determines how much of a risk you are. Risks go up based on certain behaviors, demographics, environmental factors, etc etc etc. Some people should pay more than others.

I'm glad I wasn't the only one.

I wonder how people would react if the government mandated that INDIVIDUALS MUST have a certain procedure every year and that they MUST pay for it themselves.

Why is it the government's responsibility to provide healthcare?

Insurance was originally meant to provide for catastrophic instances, not routine maintanance and general healthcare. Do you think Geico would pay for your oil changes? Why should Blue Cross pay for your innoculations? All it does is make insurance more and more costly for everyone.

Seems like there is a growing number of people who view the government as "mommy & daddy" who should take care of everything and pay for everything. Nevermind that government (in the US) is NOT a separate entity. We are a government OF the people and BY the people, not SEPARATE from the people. "Mommy and Daddy" government is actually you and me. Except in order for them to provide services, they have to charge exponentially more, because of the huge beurocracies and lobbyists out there.

 

[snappy]

I'm sympathetic to the issue however, isn't it up to the individual, privately owned insurance companies to decide what they want to cover and what they don't? Why should it be a law that they have to cover anything?

Also, even if it isn't required it doesn't mean that all, some, or even any of them will drop their coverage for it. Its probably in their best interest to cover preventitive medicine/procedures than it is to not cover them but then have to pay for treatment of the illness.

Many states already have passed laws that cover consumer protections.


Do we want to unwind these and let the insurance industry decide what to cover out of the goodness of their hearts?

Sounds like it is about $$$, not preventative medicine. Why should they cover preventative when they can just drop you later, when the diseases that used to have screenings covered start cropping up?

It is not just my view point. Check this link for a list of the organizations opposed to the bill.http://www.nationalpartnership.org/portals/p3/library/TheUninsured/S1955/OpposedtoS1955.pdf

That is a long list. I am shocked that this was kept below the radar so long.

 

[shortbun]

I don't know how much a mammogram costs without insurance but a colon screening with scope and verised costs $1,500 without insurance. This is a test all docs tell their 50yo patients they must/should have as a base line test. It could save lots of lives. I have some friends who's insurance does not cover it so they are not getting it. They have two daughters in college and both work but they just don't have $3000.00 right now for prescreening. *IF* they were having symptoms that implicated the test, it would be covered. I DO NOT want the government legislating what happens to my body. I DO want good insurance. Quagmire.

 

[The Mystery Machine]

I don't know how much a mammogram costs without insurance but a colon screening with scope and verised costs $1,500 without insurance. This is a test all docs tell their 50yo patients they must/should have as a base line test. It could save lots of lives.

I just had one which was covered by insurance and I am 41. I had a pre-cancerous polyp removed. The doc said I was lucky to have had this done NOW.

My thought on the "50" thing is that it is STUPID. I think you should have an initial screening at 40.

 

[Pea-n-Me]

Thank you for this information, snappy. My email is on its way to Senators Kennedy and Kerry.

 

[Charade]

I DO NOT want the government legislating what happens to my body. I DO want good insurance. Quagmire.

It shouldn't be. But being that the health care industry is semi-regulated, this is what you get. So you want good insurance? Just wait until we get universal health care.

I wonder what would happen if states or the feds kept their hands out of the operations of insurance companies. I do know what has happened since they started meddling, health care insurance costs have gone up.

 

[AllyandJack]

It's actually not really up to the insurance company - it's up to your employer. Your employer dictates your coverage. The insurance companies will offer everything in the hopes of getting your employer to choose everything for the most money. Your employer is the one that will choose to opt out of non-mandated coverages in the same of savings.

I seriously doubt anyone's employer will choose to drop mammogram coverage. Even if the bosses are men, they most likely have mothers, wives, daughters, etc. that will cause a huge uproar if they even think about opting out. I don't think it's a realistic scenario. I'm wondering if they're making this so that, say, a single guy can get a policy that excludes this coverage since he won't need it. Seems like an attempt to make the policy more affordable for the single man or the young woman (although that would be dangerous since even young woman can get breast cancer) so they can opt out and get the premiums reduced.

 

[snappy]

It's actually not really up to the insurance company - it's up to your employer. Your employer dictates your coverage. The insurance companies will offer everything in the hopes of getting your employer to choose everything for the most money. Your employer is the one that will choose to opt out of non-mandated coverages in the same of savings.

I seriously doubt anyone's employer will choose to drop mammogram coverage. Even if the bosses are men, they most likely have mothers, wives, daughters, etc. that will cause a huge uproar if they even think about opting out. I don't think it's a realistic scenario. I'm wondering if they're making this so that, say, a single guy can get a policy that excludes this coverage since he won't need it. Seems like an attempt to make the policy more affordable for the single man or the young woman (although that would be dangerous since even young woman can get breast cancer) so they can opt out and get the premiums reduced.

It is not just about mammograms but all kinds of sceening tests for cancer as well as other chronic diseases that workers over 50 are at higher risk for.

A more affordable policy for the young and healthy is great, if it is a choice in a cafeteria of plans. What I worry about is whether there will be the other more inclusive policies as well or only one "bare bones" policy offered. I don't mind paying the premiums for the policy I choose, I am paying the full premium for family of the insured now.

 

[suzannen]

It's actually not really up to the insurance company - it's up to your employer. Your employer dictates your coverage. The insurance companies will offer everything in the hopes of getting your employer to choose everything for the most money. Your employer is the one that will choose to opt out of non-mandated coverages in the same of savings.

I seriously doubt anyone's employer will choose to drop mammogram coverage. Even if the bosses are men, they most likely have mothers, wives, daughters, etc. that will cause a huge uproar if they even think about opting out. I don't think it's a realistic scenario. I'm wondering if they're making this so that, say, a single guy can get a policy that excludes this coverage since he won't need it. Seems like an attempt to make the policy more affordable for the single man or the young woman (although that would be dangerous since even young woman can get breast cancer) so they can opt out and get the premiums reduced.

That's not completely true. Your employer will offer the insurance options recommended by its insurance company based on what the law REQUIRES them to do at certain points in time. My company has asked for certain "extra" coverage only to be told, that this is not in their regular offerings and they cannot offer "such and such" at this time, even though our company is willing to pay the extra premium.

I really wanted to have a bone density scan before the age of 50 since all of the women in my family have a terrible history of of osteoporosis. I am also extremely high risk since I am caucasian, petite and only weigh 110 pound. The hospital fought me to even perform the bone density scan since the insurance company only covered screenings on women over 50. I insisted and the insurance was not going to pay until the results came back that I did indeed already have the start of osteoporosis. Because they caught it early, I have been put on preventive medicine and already increased my bone density and have been upgraded to osteopenia. It took months of fighting with insurance since "the law does not require this at this age." For those who don't think insurance or the government should be involved at all with insurance paying for screening tests, I say you are extremely lucky it has not affected your or a loved one yet. I was VERY lucky that mine did not involve a terminal illness, but I have lost more friends to breast cancer than I care to count. To not pay for screening that would save lives is so irresponsible to me, and all because of money.

Snappy, I sent my email and I thank you so much for bringing this to our attention.

 

[Tink9748]

I happen to work for a large health insurance carrier. Yes, there are several employers who opt not to cover any routine screening or services to their employees. The company I work for does have a list of standard services that are offered to employers. From that list they can choose to take the coverage or decline. At times, companies will ask for non-standard services to be added to their plans. Depending on whether it can be system supported as almost all claims are now processed by computers, they may be able to receive these benefits for an additional cost.

There are several states that currently have legislation in place stating insurance companies have to cover certain things. It's a no win situation. No we don't want the government to be in charge of our health insurance however in some cases they have stepped in and made insurance companies cover items that may not have been covered before.

As breast cancer has touched someone I hold dear to my heart, I to have sent my email.

Unfortunately, most of these services are expensive and without insurance alot of men and women may not have these routine services done.

 

[AllyandJack]

That's not completely true. Your employer will offer the insurance options recommended by its insurance company based on what the law REQUIRES them to do at certain points in time. My company has asked for certain "extra" coverage only to be told, that this is not in their regular offerings and they cannot offer "such and such" at this time, even though our company is willing to pay the extra premium.

I really wanted to have a bone density scan before the age of 50 since all of the women in my family have a terrible history of of osteoporosis. I am also extremely high risk since I am caucasian, petite and only weigh 110 pound. The hospital fought me to even perform the bone density scan since the insurance company only covered screenings on women over 50. I insisted and the insurance was not going to pay until the results came back that I did indeed already have the start of osteoporosis. Because they caught it early, I have been put on preventive medicine and already increased my bone density and have been upgraded to osteopenia. It took months of fighting with insurance since "the law does not require this at this age." For those who don't think insurance or the government should be involved at all with insurance paying for screening tests, I say you are extremely lucky it has not affected your or a loved one yet. I was VERY lucky that mine did not involve a terminal illness, but I have lost more friends to breast cancer than I care to count. To not pay for screening that would save lives is so irresponsible to me, and all because of money.

Snappy, I sent my email and I thank you so much for bringing this to our attention.

If the law requires it, most employers (not all - most of the time self-insured employers are exempt from any mandates) have to accept that coverage. Obviously, the insurance company representative can tell your employer that it's "worth it" to, say, include colonoscopy coverage, but if it's not mandated, your employer can toss it. If the insurance company your employer chose doesn't offer certain things they want, they can choose another provider that does offer it. That's what I was trying to say....it's up to your employer which company and which coverages you get. This is actually a GOOD thing. It's easier to raise the roof to your employer than it is to your insurance company. DH's company changed providers last year after people complained about unsatisfactory coverage. It worked. So, if you get a hint of your employer dropping coverages, get together and speak up. Sometimes it works. Sometimes it doesn't. But, that's the case for a lot of benefits. You might pay more for the better insurance company with the better options, but most people are willing to pay more for better coverage with a better company. Perhaps the employer should offer a cheaper plan for those who don't want to pay extra. That seems fair.