Lawmakers may revisit state health care insurance mandates

Georgia law provides that many health insurance policies cover certain tests and procedures, including  mammograms, pap smears, colorectal screening, ovarian cancer screening and prostate cancer screenings.

Lunsford said he is considering introducing legislation that would allow employers to offer workers the option of health policies that don't include all the now-mandated procedures and tests.

He stressed that such legislation would not try to limit cancer screenings or major tests and procedures, but rather those he believes are not necessary to save lives. He said more review would be necessary to determine the choices.

Such a measure would provide for more affordability and flexibility in health insurance plans, Lunsford said. For example, young healthy people may not need all the coverage of an older person, he said.

But some state legislators worry that efforts to change the law will chip away the number of  state mandates in policies, as well as tests and procedures covered under state Medicaid.

Rep. Mary Margaret Oliver (D-Decatur) said statements such as those of the American Cancer Society can make protecting state mandates "more difficult in the political world."

The controversy broke out after Dr. Otis Brawley, the chief medical officer of the American Cancer Society was quoted in a New York Times article Wednesday, saying that the benefits of some cancer screenings have been exaggerated. The article also indicated that the cancer society was preparing to alter its message on screenings for breast and prostate cancer, to emphasize the risk of over-treating small cancers and missing cancers that are deadly.

Brawley issued a subsequent statement Wednesday stressing that the American Cancer Society stands by its current screening guidelines.

"While the advantages for screening for some cancers have been overstated, there are advantages, especially in the case of breast, colon and cervical cancers," Brawley said in his statement.

He said that the American Cancer Society stands by its recommendation that women age 40 and over should receive annual mammograms to screen for breast cancer.

But some advocates worry that people at risk will take Brawley's criticism of some screenings as a reason not to get tested.

The criticism comes at a time when health issues -- including unnecessary tests and spiraling costs -- are under a microscope in the national discussion on health care reform.

Lunsford, the Georgia lawmaker, said many doctors order tests just to protect themselves.

"I think many tests are ordered when there are no precursors for it," he said.

Georgia has addressed the issue before. In 2005, legislators passed a law allowing  insurers to offer employees and consumers alternative health benefit plans that do not contain all the state mandates.

Lunsford said that law had little effect, as few employers used it to offer alternative policies. That law only allowed for the removal of a few mandates. None of those were cancer screenings or major life-saving tests or procedures, he said.

Any new law might provide for additional exemptions from mandates, he said, as well as update the law to account for changes in the management of health insurance plans.

Rep. Sharon Cooper, chairwoman of the state House Health and Human Services Committee, said that while she strongly supports many of the state mandates for coverage, she would be open to discuss legislation that would allow for options that don't include some mandates.

"One size doesn't fit all," she said.