Letter: Legislature can have only small effect on health insurance

As immediate past chairman of the Nevada Association of Health Plans, I'm pleased to see you identify health care as one of the important issues facing the 1999 Legislature.

However, it's unfortunate you're restricting your focus to just those patients covered by HMO plans since they represent only 24 percent of the population. By so doing, you're ignoring the health care needs of most Nevadans, including 269,000 who have no insurance at all.

The state has limited authority when it comes to regulating health insurance plans; less than one-third of the plans fall within its jurisdiction.

These include HMOs, traditional indemnity insurance and other types of prepaid and limited-service plans. More than two-thirds of insured Nevadans, however, are covered by employer-sponsored health plans and federal health programs, all of which are exempt from state law.

This much larger group includes state and federal employees, Medicare and Medicaid enrollees and many others whose employers are self-insured.

Consequently, legislative action such as mandated benefits, improved grievance and appeals processes, and the proposed ombudsman office will not affect the vast majority of Nevadans.

Typically, small employers offer managed-care health plans because of the comprehensive benefits offered at an affordable cost.

The irony of increasing demands on HMOs by mandating additional benefits and burdens through the regulatory process is that demands drive up the cost of insurance to the smaller employers who can least afford it.

Too often, the result is that fewer employers can afford to offer health insurance to their employees, and consequently, fewer people have access to any benefits at all. Everyone loses.

Quality, affordable health care for all Nevadans is the issue the 1999 Legislature needs to address.

Laws having no effect whatsoever on most of the insured population while having a negative effect upon the rest are certainly not the answer.

Marie Soldo

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