Oklahoma House of Representatives
March 2, 2004

By MIKE W. RAY
House Media Division Director
OKLAHOMA CITY -- Legislation that would extend compulsory insurance coverage to tobacco cessation programs was liked and disliked in almost equal measure by the state House of Representatives.

House Bill 2613 was defeated Tuesday by the narrowest of margins, 50-49. The bill was endorsed by 47 Democrats and three Republicans, and was opposed by 46 Republicans and three Democrats; two GOP members were absent when the vote was taken. Passage requires a minimum of 51 votes in 6the 101-member House.

HB 2613 decrees that any health benefit plan offered, issued or renewed in Oklahoma after Jan. 1, 2005, would be required to include coverage for "comprehensive tobacco dependence treatment programs..."
Opponents questioned the way in which tobacco cessation programs would be financed under HB 2613.
Rep. Joe Sweeden, author of the bill, contended that insurance companies would realize a net savings by providing health benefits for tobacco cessation programs and products such as nicotine patches and gum. Although a month's supply of nicotine patches, for example, costs about $100, insurance companies ultimately would benefit from fewer and smaller medical claims, the Pawhuska Democrat maintained.

Sweeden referred to a statement from the American Cancer Society that, "Based on cost per life year saved, treatment for addiction to tobacco products ranks higher in cost-effectiveness than virtually all other preventive health programs, including mammography, colon cancer screening, pap tests ... and pharmacological treatment of mild to moderate hypertension."

However, Rep. Carolyn Coleman suggested that Oklahomans' tobacco cessation expenses should be financed from the state's tobacco settlement trust fund, not by insurance companies.

According to the Office of State Finance, Oklahoma has already received $303.5 million from the national tobacco settlement that Oklahoma and 45 other states struck with leading tobacco product manufacturers in November 1998. Of that amount, $130.5 million has been deposited in an endowment trust fund, ledgers reflect.

In Sweeden's defense, Rep. Raymond L. Vaughn, Jr., an anti-tobacco crusader, pointed out that the trustees of the tobacco settlement fund have allocated none of the interest earnings "for treatment of addiction."

Coleman, R-Moore, asserted that while insurance companies might ultimately save money by paying tobacco cessation bills, consumers would pay higher insurance premiums because of that additional coverage.

"Consumers who don't smoke have a problem with this," she said.

Rep. Susan Winchester, R-Chickasha, indicated that insurance carriers already are burdened with mandatory coverage for myriad ailments. "We have 12 pages worth of insurance mandates now," she said.

In a similar vein, Rep. Greg Piatt pointed out that nothing in state law prohibits insurance companies from offering tobacco cessation coverage now. "A common complaint" from the Oklahoma State and Education Employees Group Insurance Board (OSEEGIB) is "the rising cost of insurance," the Ardmore Republican said.

Sweeden, though, pointed to a House fiscal impact statement which related that OSEEGIB reported that the provisions of HB 2613 "would have no material financial impact" on OSEEGIB medical claims or premiums.

Vaughn, R-Edmond, acknowledged that "many" insurance companies are voluntarily providing coverage for tobacco cessation. However, most, if not all, of those carriers are in the northwestern U.S., particularly Oregon and Washington state, he said; none of them "that I know of" is in Oklahoma, he added.

Sweeden served notice that he may call up the bill for reconsideration within three legislative days.

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