Sen. J.D. Mesnard

Sen. J.D. Mesnard (Capitol Media Services photo by Howard Fischer)

PHOENIX -- A Senate panel voted Wednesday to bar insurance companies from denying coverage for those with pre-existing medical conditions.

But some people who would be affected said there's less there than meets the eye.

SB 1397 is designed to be a fallback for Arizona residents if and when the U.S. Supreme Court voids the federal Affordable Care Act. That 2010 law provided health coverage to millions who lacked insurance and required plans to cover a list of essential health benefits.

Potentially most significant for some, it precludes insurance companies from denying coverage for those who already have medical conditions.

There are indications that the law, less formally known as Obamacare, will be struck down because a central provision of the act -- the requirement of individuals to purchase health insurance -- has effectively been repealed. That undermines an earlier Supreme Court ruling which upheld the law on the basis that the purchase requirement fits within the power of Congress to impose taxes.

The attacks on the law have been led by Republicans, including Arizona Attorney General Mark Brnovich who signed onto legal briefs asking the justices to void the statute.

But that, in turn, has created a potential political problem for the Republicans given the popularity of the provision on pre-existing conditions. So last year Brnovich along with Sen. J.D. Mesnard, R-Chandler, and Jeff Weninger, R-Chandler, announced they would craft something to fill the gap should the Affordable Care Act go away.

On paper, SB 1397 does that. It spells out that if the Affordable Care Act is invalidated that insurance companies cannot decline to offer coverage to any individual or impose limits on preexisting conditions.

But Cindy Komar, who said her son suffers from severe hemophilia, said a simple promise of coverage, absent some limits on premiums and deductibles that are part of the federal law, isn't really any help at all.

And Kimberly Dorris, who told lawmakers she suffers from Graves' disease, suggested this legislation appears to be little more than a bid by Republicans to save political face now that they're on the verge of killing popular legislation.

Mesnard, for his part, does not dispute that the legislation is not the Affordable Care Act. Nor, he said, is it his desire to re-create it here in Arizona.

"What I was trying to do is pick the common denominator that both side of the aisle have agreed to,'' Mesnard said.

More to the point, he said he wants to "stay narrow,'' warning that any effort to impose additional requirements on insurance companies on the coverages they provide -- and what they can charge for them -- is unlikely to get the necessary votes for approval in the Republican-controlled Legislature.

And Brnovich, in a letter to committee members, called what's in SB 1397 a "measured, common-sense proposal that provides a basic safeguard that most Arizonans support in the event the Affordable Care Act is struck down.''

What's missing in SB 1397, Komar told lawmakers, is the "affordable'' part.

She said the medication her son takes to ensure his blood can clot costs $40,000 a month.

Komar said that while SB 1397 would guarantee that she could get an individual health insurance policy for her son, a company could decide to impose a $10,000-a-month deductible.

"We cannot afford that,'' she said.

Komar said that, absent some requirement for an affordable policy, her son may go without insurance. And if he has some sort of incident, he will wind up in the emergency room where the bill could end up being $2 million, a bill she said would be paid by the state.

What Komar said is needed are things like limits on deductibles and lifetime caps.

"Go back and do some more work on it,'' she urged.

Dorris said she was suspicious from the announcement last year about the intent to deal with pre-existing conditions that the proponents were actually going to provide meaningful protections.

"It was big on hype but sketchy on details,'' she said, concluding it was "merely an effort to garner publicity and to dupe voters,'' especially with Brnovich playing a role in trying to kill the Affordable Care Act and, along with it, the protections for patients with pre-existing conditions. Dorris said what has emerged in SB 1397 has not convinced her otherwise.

"You can pass a law that forces insurers to sell us a policy,'' Dorris said.

"But will it cover specialists, lab tests and medications?'' she continued. "Will premiums be deliberately set at unaffordable rates?''

Mesnard said he's willing to listen to ideas to improve the measure when it goes to the full Senate, "within reason.'' But he said that those who complain the scope of the bill is too narrow need to realize the alternative: "If Obamacare is struck down as I think it inevitably will be at this point ... there is nothing.''

Sen. Sean Bowie, D-Tempe, agreed to support the measure, calling it "better than nothing.''