Health care coverage option for business worries patients, caregivers

Gets regular mammograms
Patient Fay Brackett says it would be a mistake if health plans decided not to cover certain cancer screenings just to offer cheaper insurance.
MPR Photo/Lorna Benson

The American Cancer Society says if the Senate bill is approved, thousands of Minnesotans could lose insurance coverage guarantees for mammograms and other cancer screenings. Minnesota is one of 49 states that requires coverage for mammograms, along with screenings for prostate and cervical cancer.

Cathy Peters, a policy researcher for the American Cancer Society, says the Senate plan would allow health insurers to skirt state requirements so they could offer cheaper health insurance plans.

"We don't feel like the trade off is worth it, the idea of covering a few more people, but then also wiping out some certain benefits to people who are currently insured. You know the tradeoff isn't worthwhile," she says.

Dr. Thomas Flynn agrees.

Create a More Connected Minnesota

MPR News is your trusted resource for the news you need. With your support, MPR News brings accessible, courageous journalism and authentic conversation to everyone - free of paywalls and barriers. Your gift makes a difference.

The mandates certainly affect the premiums. There's no question about that.

Flynn treats cancer patients at the Minnesota Oncology Hematology clinic next door to Abbott Northwestern Hospital in Minneapolis.

"I think it's disconcerting if there's anything done that reduces the access of individuals to these screening techniques which are known to be effective," he says.

Dr. Flynn says regular screenings make it possible to detect cancer in the early stages of the disease. He says earlier detection saves lives and it can reduce treatment costs. But he says studies show that patients are less likely to get the procedures if they don't have insurance coverage that pays for screening.

Across the hall from Flynn, at Fay Brackett is getting her annual mammogram at the Piper Breast Center. Brackett says she would probably pay for her annual mammogram out of pocket if her insurance didn't pay for it. But she suspects many other women would not.

Brackett says she couldn't imagine not having a regular mammogram after experiencing a health scare last December. That's when a diagnostic mammogram revealed a possibly cancerous cyst in her breast. She says further testing showed that the cyst was not cancerous.

"It took a lot of worry away," she says. "They tested for cancer and, no it wasn't there. And boy I've lived the last three, four months not thinking about that, and just coming back in for a routine mammogram."

But some business interests argue that these state-mandated tests add significantly to the cost of insurance.

Dr. Thomas Flynn
Dr. Thomas Flynn says mammograms and other types of cancer screenings often detect the disease earlier and are more cost-effective than treating cancer in later stages.
MPR Photo/Lorna Benson

"The mandates certainly affect the premiums. There's no question about that," says Julie Brunner, Executive Director of the Minnesota Council of Health Plans. Brunner's group represents state insurers. Brunner says the council hasn't taken a position on the bill. She says her membership would probably agree with some aspects of the plan. But she says the bill doesn't address the biggest expenses in health care which include new technology, prescription drugs and increased utilization of health care services.

"It's unclear to me how there will be a direct impact on sort of that overall cost of health care because it isn't attending to the drivers of care other than to eliminate a service."

Brunner says she's not sure whether insurers in the state would even offer scaled-back plans. She says Minnesota lawmakers passed legislation last year that allowed health plans to offer similar plans on a limited basis. She says there was virtually no demand from employers for that type of product, so none of the insurers offer it.

But Jim Fries with the Minnesota Chamber of Commerce believes there would be demand for these insurance plans if more employers knew about them.

Fries says there was very little communication with Minnesota employers about the state insurance exemption.

"If you do it at a federal level then I think that generates much more publicity and more employer awareness than it did last year at the state level," he says.

The proposed bill would allow some small businesses to partner to offer their workers limited health insurance. Supporters of the bill say that would reduce the number of uninsured people in the U.S. by giving small employers more purchasing power in the health insurance market.