Insurers to pay for artificial limbs under House bill

• By MARK BALLARD
• Advocate Capitol News Bureau
• Published: Apr 10, 2008 - Page: 6A - UPDATED: 12:05 a.m.

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Louisiana health insurers would have to provide coverage for artificial limbs under legislation endorsed Wednesday by a House committee.

House Bill 318 would require health insurance policies to pay up to $50,000 per limb, per year, for customers requiring prosthetic devices and services.

About 1 million of the state’s residents would be covered by HB318, said John Rush, a chief medical officer of Orthopedic Group Inc. of Bethesda, Md., who testified in favor of the legislation.

Most large companies have plans that are covered by the federal government under the Employee Retirement Income Security Act, or ERISA, and would not be covered by HB318. Ten states have the legislation and 14 others have introduced similar measures before their legislatures, Rush said.

The U.S. Congress is considering a similar mandate for health plans covered under ERISA, Rush said.

Carl Falconer of Baton Rouge, who testified in favor of HB318, was crushed by a speeding car after stopping to help a woman change a flat tire in July 2007. Both legs were amputated, and he was told that his insurance would pay only $5,000 on prosthetic devices that would cost $40,000 for each limb.

“How would I take care of my family?” Falconer said. “What are your limbs worth to you?”

Officials of groups who said they represent small businesses opposed to the legislation, calling it yet another coverage and another cost that employers would have to pay.

Rep. Kevin Pearson, R-Slidell, noted that if enacted into law, HB318 would become the 44th such mandate.

Renee Baker of the National Federation of Independent Business’ Louisiana chapter said her association’s statistics indicate that for every 1 percent increase in premium price, 20,000 Louisiana residents lose their health insurance.

“The reason for the opposition of business and health-care insurers is more of the cumulative effect,” said Gil Dupré, chief executive officer of the Louisiana Association of Health Plans.

Bridgette Richard, director of the Health Care Task Force of the Louisiana Association of Business and Industry, testified that her organization represented small businesses, and they opposed the measure as another mandate that would increase the cost of insurance for employers.

Committee Chairman Rep. Chuck Kleckley, R-Lake Charles, interrupted and said, “You’re being inconsistent.” He recalled that last year he pushed a bill that would have helped small businesses but LABI refused to support it.