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Legislative Memo

Lev Ginsburg
Director of Government Affairs
T 518.694.4462
www.bcnys.org

BILL:

S.6882-A (Tedisco) / A.8683-A (Gottfried)

Support

SUBJECT:

An act to amend the public health law, in relation to the written summary relating to prostate cancer; and to amend the insurance law, in relation to coverage of diagnostic screening for prostate cancer

 

DATE:

April 20, 2018

 

The Business Council opposes S.6882-A (Tedisco) / A.8683-A (Gottfried), which would require health plans to provide coverage of prostate cancer screenings without any cost sharing requirements.  While well intentioned, this bill would drive up the cost of health insurance plans to individuals and employers in order to cover services that are not scientifically supported as an effective method of preventive screening.

The American Cancer Society recommends that men over the age of 50 start the discussion with their physician to be tested for prostate cancer, but do not necessarily recommend getting preventative screenings due to the risks associated with the screenings.

In recent findings from the U.S. Preventive Services Task Force, found; “Screening offers a small potential benefit of reducing the chance of dying of prostate cancer. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible over-diagnosis and over-treatment.” This task force went on to give these preventive screenings a “C” grade and only recommend selectively offering or providing this service to individual patients based on professional judgement and patient preferences. They highly discourage broadly covering and providing this service to all patients and it only has a small net benefit.

When New York State established its health benefit exchange, as part of the Affordable Care Act (ACA), it defined a comprehensive set of benefits and services known as the “essential health benefits” (EHB) that must be included in every health insurance policy without any cost sharing requirements. This list of EHB in New York State was much more comprehensive than the federal mandated set of benefits. However, even with this much more comprehensive list, the New York State EHB list did not include prostate cancer screenings because of this “C” grade and the small net benefit provided to an only negligible set of patients.

The rising cost of health insurance continues to be one of the top concerns for the majority of businesses across the state. Large businesses are required to provide health insurance, while small businesses want to provide health insurance to their employees. Mandates of this type, which increase the costs without substantially increasing the quality of care, are funded on backs of employers and employees alike. This mandate will continue to drive up the cost of health insurance to businesses across the state and make New York even less friendly to business.

For these reasons, The Business Council respectfully urge the rejection of S.6882-A / A.8683-A.