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SPONSOR: |
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HB |
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SHORT TITLE: |
Smoking Cessation & Prevention Insurance |
SB |
743 |
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ANALYST: |
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APPROPRIATION
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY03 |
FY04 |
FY03 |
FY04 |
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See Narrative |
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Relates to HB 144, SB 133 & SB 534
Responses
Received From
Public
Regulation Commission (PRC)
Department
of Health (DOH)
Human
Services Department (HSD)
Retiree
Health Care Authority (RHCA)
Public
School Insurance Authority (PSIA)
SUMMARY
Synopsis
of Bill
Senate Bill 743 amends
the Insurance Code to create a mandated benefit of smoking prevention and
cessation treatment in an individual or group health insurance policy, health
care plan or certificate of health insurance delivered, or issued for delivery,
in this state that offers maternity benefits. The mandated coverage may be
subject to the policy deductibles, coinsurance and co-pays.
Significant Issues
There is conclusive
evidence that smoking has an adverse affect on health. Smoking during pregnancies also affects the
health of the new born. Proponents of SB
743 believe that this coverage will improve health and ultimately lower the
cost of health insurance.
Opponents of SB 743
argue that this is another mandated benefit that will drive up the premiums for
of health insurance.
FISCAL IMPLICATIONS
There is no immediate
fiscal impact of SB 743. There is, however, disagreement about whether mandating
smoking cessation and prevention will ultimately raise or lower health
premiums. The premiums affect the state since the employers share of premiums
is paid by the Risk Management Division of the General Services Department for
the active state employees, the PSIA for the public school employees and the
RHCA for the retirees.
Some experts believe
that mandating any coverage will increase premiums. Others argue the overall
health benefits of stopping smoking will ultimately result in healthier covered
individuals and save money in the long run.
ADMINISTRATIVE IMPLICATIONS
Insurers will be required to refile policy forms
and premium rates with the Insurance Division of the PRC, but the
administrative impact is minimal.
RELATIONSHIP
SB 743 relates to:
HB 144 and SB 133,
which propose tobacco settlement program fund appropriations for FY04, including prevention and cessation programs, on behalf of
the recommendations of the Tobacco Settlement Revenue Oversight Committee.
SB 534, which proposes
tobacco settlement program fund appropriations, including prevention and
cessation programs.
TECHNICAL ISSUES
The DOH recommends changing “smoking “ to
“tobacco use”, such that it incorporates all forms of tobacco (e.g., spit
tobacco) in the following sections:
Title, Page 1 Line 12,
Section 1, Page 1, Lines 17, 22 and 24
Section 3, Page 8, Line 5
Section 4, Page 10, Line 12
Section 6, Page 12, Line 13
OTHER SUBSTANTIVE ISSUES
DOH provided the
following:
Tobacco exacts a heavy
death toll in our state. More than 2000
New Mexicans die each year from smoking-related conditions, and more than 2000
children in the state have lost at least one parent as a result of tobacco
use. If current trends continue, the
number of New Mexicans currently under age 18 who will ultimately die from
smoking is estimated at 44,000.
Treating tobacco
dependence is the most important action health care providers can take to improve
the length and quality of life for patients who smoke. Patients would benefit
if systems were in place to ensure that preventive healthcare is addressed at
each patient visit. The influence of health care system administrators,
insurers and purchasers could be used to encourage and support the consistent
and effective identification and treatment of tobacco users.
Smoking cessation
treatments are not only clinically effective, but they are economically defensible
as well. Cost effectiveness analyses have shown that smoking cessation
treatments compare quite favorably with routine medical interventions such as
the treatment of hypertension and other preventive interventions such as
periodic mammography.
Savings from
prevention and cessation treatments are immediate and measurable. For example,
Smoking cessation is
also cost effective in special populations such as hospital patients and
pregnant woman. Every dollar spent on trying to get pregnant women to stop
smoking can save $6 in long-term costs. Smoking cessation interventions for
pregnant women are especially cost effective because they result in fewer low birth
weight babies and perinatal deaths, fewer physical, cognitive and behavioral
problems during infancy and childhood, and also yield important health benefits
for the mother.