Cost Versus Coverage; Schwarzenegger Weighs 10 Bills to Expand Health Insurance

Gov. Arnold Schwarzenegger is considering 10 bills that would expand what health insurers are required to cover in California. The measures would require insurers to pay for HIV tests for people without symptoms of the infection; human papillomavirus testing; maternity services; mental health disorders; cleft palate dentistry; durable medical equipment; and hearing aids for children.

Combined, the mandates would increase premiums by $383 million annually, or 0.5 percent of the $74 billion employers and individuals pay for health insurance each year, the California Health Benefits Review Program at the University of California (UC) estimates. The broadest requirement would enhance coverage for 18 million Californians; the narrowest would assist a few hundred patients.

The state already requires insurers to offer 44 benefits, more than most other states. However, not every policy has to include all 44. While managed care plans must cover all medically necessary procedures, some plans only offer catastrophic coverage.

Medical providers say highly profitable insurance companies can afford to absorb some of the costs of expanded coverage. But "the insurers oppose anything that costs money," said Dr. William Hoffman, chief of plastic surgery at UC San Francisco Medical Center and a supporter of the bill to require coverage of cleft palate correction.

Chris Ohman, president of the California Association of Health Plans, an HMO trade group, said industry opposition is based on cumulative cost, not the price of each individual mandate.

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