ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, February 29, 1996 TAG: 9602290075
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
DATELINE: RICHMOND
SOURCE: DAVID M. POOLE STAFF WRITER
Sen. Louise Lucas was about to burst an artery as she listened to two men - a Senate colleague and a lobbyist - discuss women's access to gynecological care.
``If you don't let me speak,'' Lucas erupted, ``I'm going to need a cardiologist.''
The Portsmouth Democrat proceeded to tell the Senate subcommittee how close she came to death 14 years ago because the men in her life, including her family doctor, told her she was too young for a hysterectomy.
``I'm trying not to get emotional, but some of us do have some personal experience here,'' Lucas said. ``I'm having a lot of trouble listening to all this garbage about limiting access.''
Emotion is the driving force behind a General Assembly bill that would allow women enrolled in managed care health plans to visit their gynecologists without referrals from their primary care physician.
Insurance company representatives warn that a host of unintended consequences would result from the bill that has passed the House of Delegates and is pending in the Senate. But their policy arguments appear to be no match for the appeal of an idea that has become as sacred as motherhood and apple pie.
``Some bills just take on a life of their own, and this is one of them,'' sighed May Fox, a lobbyist for the Virginia Health Maintenance Organization Association.
The measure - House Bill 442 - arises from a growing consumer frustration with restrictions that some insurance plans place on specialized health care in an effort to control costs.
Proponents of HB 442 say that, because gynecologists are the primary care givers to many women of childbearing age, it makes no sense to place ``gatekeepers'' between women and these specialists.
Fairfax County Del. Gladys Keating, the bill's sponsor, said many insurance plans make it costly, inconvenient and sometimes impossible for women to be referred to gynecologists.
Opponents note that unrestricted self-referral to specialists goes against a fundamental principle of managed care. Bypassing the primary care physician will bring uncoordinated care and escalating costs, they say.
These arguments, however, were ignored when the House voted 95-3 for a version of HB 442 that was more sweeping than even some supporters had requested.
The bill's emotional pull has forced a coalition of insurers and businesses to rethink its lobbying effort in the state Senate.
Careful not to appear insensitive to women, the coalition has dispatched its female lobbyists to do most of the one-on-one talking with senators.
Sandra Bowen, a state Chamber of Commerce official, contends that the bill could be bad for women because it could cut their primary care physician out of the loop.
``I want someone looking at the whole picture,'' Bowen said. ``There are other issues of my health that are not entirely female.''
Bowen also noted that the bill would not cover state employees or poor women on Medicaid.
The business coalition has offered a compromise: Managed care plans would allow women to go directly to their gynecologists for an annual examination and any follow-up care arising from that visit. Any subsequent visits, however, would need approval by the primary care physician.
Some supporters say the compromise is all they have wanted all along. But Keating refuses to bite, saying that any change could endanger the bill by requiring a second House vote.
``I just don't want to touch it; let's just get it out of here,'' she said Tuesday when the bill was aired before a Senate Education and Health subcommittee.
The panel did just that, voting 4-0 to recommend approval of HB 442.
The business coalition will look for an opportunity to offer its compromise today when HB 442 comes before the full Education and Health Committee.
The bill, however, is being pushed along by deep emotional currents.
Planned Parenthood lobbyist Karen Raschke marveled at how the bill resonates even with conservative senators who usually side with the business community.
``They are telling me something I have never heard on any other issue,'' Raschke said. ``They say, `My wife wants me to vote that way.'''
LENGTH: Medium: 84 lines ILLUSTRATION: GRAPHIC: Chart by staff: Access to OB/GYN care. color. KEYWORDS: GENERAL ASSEMBLY 1996by CNB