Privacy proposals will be one of the most prevalent — though not the most hotly debated — issues related to health coverage in state houses this year, according to a survey by the Health Insurance Association of America. Prescription drug coverage, prompt-payment mandates, and so-called "legislation by body part" aren't far behind.of America. Prescription drug coverage, prompt-payment mandates, and "legislation by body part" aren't far behind.
The push for privacy legislation will stem from Congress's passage of the Gramm-Leach-Bliley Act, which gives health insurers a broad mandate for managing and protecting medical information, but leaves it up to states to hammer out the how-to. States' need to respond will result in legislation in almost every capitol this year.
Programs to help elderly and low-income people pay for prescription drugs, which passed in 24 states last year, will also have high visibility again this year. This may be the most explosive issue at the state level; pharmaceutical companies will watch carefully as states craft discount programs (see item about Maine at right).
A hot button at the state level last year — liability — will be less important this year. Thirty-two states debated liability last year, but only one bill passed. Liability measures have been introduced in eight states this year and may be crafted in as many as 12 more, but HIAA says the advent of external-review laws — passed so far by 40 states and the District of Columbia — has, for now, cooled passion for liability laws.
As for coverage mandates, HIAA expects the more popular proposals this year to include coverage for clinical trials, infertility, and mental health parity, among others.