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Health plans warn HB 33 mandating prostate screening at 40 could raise premiums
Summary
The Ohio Association of Health Plans told the committee HB 33 would require coverage without cost sharing for prostate screening beginning at age 40 and cautioned that plans already cover medically necessary screenings and that mandated changes may raise premiums.
Megan Richwine, director of government affairs for the Ohio Association of Health Plans (OHP), testified in opposition to House Bill 33, which would require insurers to cover prostate-cancer screening without cost sharing starting at age 40.
Richwine said health plans already cover medically necessary prostate screenings but warned that HB 33 would change the age and frequency for coverage and could increase health-care costs that affect premiums. She cited the U.S. Preventive Services Task Force guidance, noting it gives screening of asymptomatic individuals ages 55 to 69 a "C" rating and that screening policies require a careful cost-benefit analysis. "The state should not require health plans to cover and thereby incentivize screening for prostate cancer when there is no consensus within the medical community about the age and frequency at which prostate cancer screenings are most beneficial," Richwine said.
Committee members compared HB 33 to prior legislation that removed cost sharing for breast-cancer screening, discussed medical-economic tradeoffs such as number-needed-to-treat and downstream biopsy/treatment costs, and asked OHP to follow up with examples where coverage was denied despite claims of 'medically necessary' screening. The committee concluded its third hearing on HB 33 after Q&A.
