MEMORANDUM IN OPPOSITION

Date: June 01, 2010
Bill:Bill: S7408-A (Breslin) / A10219-A (Jacobs)

Act to amend the insurance law in relation to drugs used in cancer treatment

The Employer Alliance for Affordable Health Care is a grassroots coalition of more than 3,000 sole proprietors and small and medium-sized business owners who represent more than 150,000 working New Yorkers. Our members believe that everyone should have access to basic, affordable health insurance. We oppose health insurance mandates that increase premium costs and decrease accessibility of basic, affordable health insurance. This bill seeks to amend update New York’s existing reimbursement policy for pharmaceutical products used in cancer treatment.

WE OPPOSE THIS LEGISLATION FOR THE FOLLOWING REASONS:

• While the purpose of this legislation is to bring New York’s reimbursement of drug utilization in cancer treatment in line with federal policies, the proposal, in and of itself, highlights one of the critical problems related to health insurance mandates. Scientific treatments and medical recommendations continually evolve while state legislation, such as this, remains static. Several of New York’s cancer treatment and testing guidelines remain outdated due to recent scientific breakthroughs. While the intention of this legislation may be to align New York with pharmaceutical reference industry changes, this proposal – in and of itself – highlights the danger of the state’s involvement in private health insurance. Mandates are status, while science is dynamic.
• Cancer is not a one-size-fits-all disease, while mandates, including prescription used in treatment, offer cookie cutter solutions. The patient and his or her healthcare provider should have the discretion to determine the appropriate course of treatment based on the latest scientific information.
• This, like all health insurance mandates, drive up cost. In 2010, a total of 14.2% of premiums paid per policy holder, per year were needed to fund the 51 mandates required in New York State (Health Insurance Mandates in New York State 2003/NovaRest Consulting and Report by the Superintendent of Insurance on the Cost and Effectiveness of New York’s 2006 Mental Health Parity Legislation). The state should not exacerbate health insurance costs, but instead seek to be part of the solution.
• Before adopting this or any other mandated benefit, we ask that the Legislature complete the process of establishing the Health Care Quality and Cost Containment Commission started in 2007 which will be responsible for studying the impact of such mandates prior to passage.

The Employer Alliance for Affordable Health Care is a coalition of more than 3,400 employers and individuals from across New York, representing more than 200,000 working New Yorkers, committed to preserving quality affordable health care.