S.3478 (Gipson) / A.5174 (Cahill)


Director of Government Affairs
518.465.7517 x207


S.3478 (Gipson) / A.5174 (Cahill)


Lyme disease and other tick borne related pathogen coverage mandate and workers' comp presumption



The Business Council of New York State opposes S.3478/A.5174, as it imposes an open-ended insurance coverage mandate on health insurance plans in New York State. The bill provides no requirement that "further treatments" be evidence based, peer reviewed or clinically proven; it increases costs on taxpayers who fund the employer share for public employee health benefits; and will increase costs for individuals and employers in New York State.

The addition of Lyme disease and other tick-borne illnesses to the list of occupational diseases compensable under the Workers' Compensation Law will add significant expense to a system already under serious financial strain. Lyme disease and other tick-borne illnesses can be contracted in almost any place at any time.   The workers' compensation system is designed and meant to compensate injured employees for workplace injuries. Since there is absolutely no way to determine when or where Lyme disease and other tick-borne illnesses are contracted, this bill would lead to presumptive comp determination based on non-workplace injuries and place a new, costly and unfair mandate on New York job creators.

Insurance mandates drive up costs for all employer-sponsored plans, and those in the small group, community-rated market are hit the hardest. This bill will drive costs up even further while providing no reasonable limitations on untested treatments. Additionally, taxpayers will shoulder an increased burden to absorb the increases associated with the "employer" share of public employee health benefit plans at all levels of government.

In 2007 the Legislature created the New York State Health Care Quality and Cost Containment Commission, which was charged with analyzing the impact on health-insurance costs of proposed legislation that mandates health benefits be offered or made available in individual and group health-insurance policies, contracts and comprehensive health service plans. The Commission was also directed to study the delivery of health benefits or services and the reimbursement of health care providers. Unfortunately, this Commission has yet to be appointed or meet. Any discussion of additional coverage mandates should be held in abeyance until such time as the Commission is functioning and cost/benefit analysis and reports can be conducted.

Finally, this bill ignores the pending implementation of aspects of federal health care reform which require state-imposed insurance mandates, in excess of those required in the federal essential benefits menu, to be paid for by state revenues – not premium dollars.  Now is clearly not the time for the state to show a lack of fiscal discipline and impose costly coverage mandates for which they have identified no revenue source to pay.  

For these reasons, The Business Council opposes this bill.