LEGISLATIVE POSITIONS ADOPTED
BY THE NCCBI HEALTH CARE COMMITTEE

MANDATED BENEFITS

POSITION: NCCBI opposes in principle any efforts to mandate or require employers to provide specific benefit coverage under group health care plans. Employers are encouraged to offer health care coverage consistent with their ability to afford them and to promote good health.

EXPLANATION: An increasing number of proposals for the mandating of benefits have been considered by the General Assembly in recent years. The cost ramifications of mandating health care benefits have resulted in a growing concern on the part of the business community, particularly when viewed in the context of present health care cost increases.

Therefore, all proposals for mandated benefits should be examined carefully in light of this concern.

NCCBI urges state legislators to proceed cautiously on benefit mandates by:

· Requiring that all benefit mandate legislation include an economic impact statement on new costs created by the mandate and the likely impact of these costs on the availability and the affordability of insurance coverage in North Carolina; and

· Referring all benefit mandates to a single committee in the House and in the Senate, so that a vigorous debate of the cumulative impact of these mandates is possible; and

· Requiring that the Teachers and State Employees Comprehensive Major Medical Plan cover any new benefit mandate for at least one year before requiring private employers to cover the mandated benefit.

EXPANSION OF MEDICAL MALPRACTICE LIABILITY

POSITION: NCCBI strongly opposes proposals which would expand

medical liability to include employers and health plans.

EXPLANATION: NCCBI opposes expansion of medical liability to employers and health plans for several reasons. First of all, the threat of lawsuits would discourage many employers from offering insurance at all, thereby leaving millions of Americans uninsured. According to a U.S. Chamber of Commerce study conducted in February, 1998, 57% of employers say they would be likely to stop providing health care coverage for their employees and dependents if expanded liability is passed.

Secondly, expansion of medical liability goes against the business community's long-standing support for tort reform because it would only create more expensive lawsuits and court delays. A New York Times editorial in April, 1998 says "jury awards in state courts for malpractice are notoriously capricious and do more to reward lawyers than patients."

Lastly, NCCBI opposes expanding this liability to health plans because, under current ERISA law, a patient can already sue his/her health plan in federal court, and the court may award attorney's fees, court costs, and the value of the benefit denied.

MANDATED DIRECT REIMBURSEMENTS

POSITION: Generally, NCCBI opposes legislative efforts to mandate insurance companies to directly reimburse non-physician health care providers.

EXPLANATION: Several non-physician health care providers have petitioned the General Assembly from time to time to require insurance companies to reimburse them directly for their services.

Presently, the N.C. General Statutes require direct reimbursement to some licensed providers who can practice without the supervision of a physician.

Direct third-party reimbursement to a non-physician health care provider most likely serves to increase the cost of health care. The non-physician health care providers requesting direct third party reimbursement may not take the place of any existing health care provider now providing those services. Instead, we may simply have more providers in the market place providing the services and receiving reimbursement. In most instances, the care is already provided in a cost-competitive manner.

Therefore each proposal for direct reimbursement should be examined carefully in light of these concerns.

LONG TERM CARE INSURANCE INCENTIVES

POSITION: NCCBI supports incentives such as tax credits for individuals to promote the purchase of private long term care insurance. NCCBI also supports recent activity on long-term care legislation by the North Carolina General Assembly and the United States Congress, but feels that the legislation may need to be reexamined at some point in the future if it is not adequate.

EXPLANATION: Nearly three-quarters of all the patients in North Carolina's nursing homes rely on the Medicaid program to pay for their care. With the aging of the population, this will likely put more upward pressure on Medicaid spending in the future. At least part of this pressure can be alleviated by the private sector through the increased use of long term care insurance. Currently, less than two percent of nursing patients have such insurance to pay for their care. Incentives such as tax credits for premium payments would eventually lead to less reliance on government sponsored programs and more personal responsibility for the financing of long-term care (including nursing homes and home health care).