State may require coverage of testing

Proposed bill number 673 is a lesson in civics, and the ability of ordinary citizens to set the agenda of the state’s governing body.

A few months ago, State Senator Mary Ann Hadley (D-4) received a letter from a constituent in the mail. In the letter, a Glastonbury, Conn. couple urged Handley to introduce a bill that would force insurance companies to cover testing for potential bone marrow donors. Handley said her office receives numerous letters and phone calls suggesting legislation, but the Gallivans’ letter stood out.

“Their story and their argument was so persuasive that I thought we should at least have a public hearing and let the issue be debated,” Handley said. “You know, you hear a lot about grassroots action and ordinary citizens changing things, but the fact is that they can and they do.”

Most insurance companies pay for the bone marrow transplant procedure once a donor is found, but few will cover the $50-$65 cost of preliminary donor testing. While the procedure is simple, not everyone who wants to donate can afford to pay, said State Representative Russell Morin (D-28), a co-sponsor of the bill.

Morin said he first recognized the difficulties of donor testing while helping to run a fundraiser for a family friend with cancer.

“It was an emotionally draining experience for one, and secondly, it was a shame that the people who were trying to help had to pay for it,” he said. “Something’s got to be done to try to make it easier.”

Patients in need of a bone marrow transplant require a matching donor, and though there is a national marrow registry that tracks donors, many patients have a difficult time finding someone compatible. One barrier to adding potential donors to the national registry is the cost of the testing procedure, said Regan Hall Reinerth of the National Marrow Donor Program, which maintains the registry.

Even though the cost of testing one individual may not be overwhelming, bone marrow drives that draw hundreds of people can become expensive propositions, Handley said.

The legislation, if passed, will force insurance companies to pay for individuals who want to be tested. But it is unclear what impact this mandate would have on Connecticut insurance companies.

Deborah Hoyt, a spokeswoman for Aetna, said her company already covers testing costs for most potential donors. Aetna will cover first-round testing for anybody likely to be a match for one of its clients in need of a transplant, like close relatives and spouses. Though Aetna will not pay to test non-subscribers who are not relatives of the recipient, it will pay for the costs of second-round testing and transplant if such individuals are found to be a potential match for an Aetna client. Potential blood marrow donors must first undergo a DNA swab test, which involves the collection of cells from inside the cheek. Second-round testing is more involved and requires blood sample analysis.

“The bill as we read it won’t make us do anything more than what we’re doing now,” she said. “We feel good about the fact that we’re already in front of what the legislation wants to mandate.”

The Public Health Committee has yet to consider either Handley’s bill or a similar, independently proposed bill. A public hearing on the legislation will be held on Wednesday morning, though the committee will not have to vote on the bills until early March. The bills’ final status may remain unknown until early May.

Morin and Handley say they do not know whether their bill has enough support to move through committee and a general vote. In his experience, Morin said, he has found that committees generally do not like to force mandates on insurance companies. Still, both co-sponsors say they are pulling for it.

“It seems to me a very good thing,” Handley said. “If all goes well, I think it will move along.”

If the bill does ultimately pass, Connecticut will join a number of neighboring states — including Massachusetts and New Hampshire — that mandate insurance company coverage of marrow donor testing.

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