Copyright 2009 North Jersey Media Group Inc.,All Rights Reserved Herald News (Passaic County, NJ) October 21, 2009 Wednesday
SECTION: NEWS; Pg. A01
LENGTH: 1128 words
HEADLINE: The truth about mammograms; Sides exaggerate claims about savings and loss of coverage
BYLINE: By LINDY WASHBURNand JOHN REITMEYER, Staff Writers, North Jersey Media Group
Voters are hearing a lot about mammograms in campaign commercials, but what they're getting are exaggerations that ignore basic facts about health insurance in New Jersey.
Since Labor Day, Governor Corzine has been hammering his claim that Republican challenger Chris Christie's plan for mandate-free health insurance will end mammogram coverage for at least some women. The strategy has worked: While Corzine trailed in most polls before the attack ads, he and Christie now appear virtually tied.
Christie's original claim that eliminating mandates will drive down premiums and cut the number of uninsured, and Corzine's counterclaim that women will be deprived of coverage for the breast-cancer screening test if mandates are lifted, are both exaggerated.
Health experts don't believe insurance in New Jersey would be measurably cheaper or more accessible if mandates are lifted because they are not among the primary factors driving up costs.
And under the status quo Corzine defends, more than 60 percent of insured New Jersey residents are not subject to state mandates such as the one that requires mammogram coverage.
Right now, insurance benefits in New Jersey must include a baseline mammogram for women ages 35 to 40 and annual exams after that; younger women with a high risk of breast cancer must receive coverage for mammograms as often as their health provider deems necessary.
But in New Jersey, only one-third of the state's insured residents are in plans regulated by the state, with the 45 mandates that come along with that coverage.
The rest are in Medicare, which covers mammograms, but doesn't mandate them; Medicaid, which covers mammograms, according to guidelines from the federal Centers for Disease Control and Prevention; and self-insured plans, whose oversight does not mention mammograms. Low-income women have access to the screenings, if their insurance doesn't cover them or they are uninsured, thanks to other programs.
Christie, whose mother was diagnosed with breast cancer through a mammogram when he was 18, has said that no one who lived through that experience "would ever sign a law or allow regulation that would prevent any woman from being able to get a mammogram."
He said he's seeking to make health insurance less expensive so that more of the state's 1.2 million uninsured can afford it.
Christie would do that by allowing insurance companies to sell a variety of policies, in addition to those that include mandated benefits, and by allowing out-of-state companies to compete for insurance customers.
"Right now, New Jersey has 45 mandates, which drive up the cost of health care plans and make it virtually impossible for some New Jerseyans to afford coverage," his Web site says.
But Christie is overstating the impact of health insurance mandates. New Jersey's high health insurance premiums have much more to do with the heavy use of medical services by state residents, the constantly increasing cost of medical technology and high labor costs here, experts say, than they do with mandates.
When it comes to mandates, New Jersey is in the middle of the pack nationally: 20 other states have more.
And the effect of these mandates on costs is not as obvious as it seems. The insurance industry's own Council on Affordable Health Insurance estimates that most mandated services, including mammography, raise costs by less than 1 percent.
"There's always a knee-jerk reaction that it adds costs, but it's not clear," says a health economist who has studied insurance mandates, Dr. Alan Monheit of the University of Medicine and Dentistry of New Jersey's school of public health. "It's very hard to generalize that if you remove mandates you would reduce costs."
Mandates are passed because people value the coverage they provide, Monheit says, and mammography in particular is a very popular mandate.
"If you removed mandates," Monheit said, "individuals might not value the coverage they're getting."
New Jersey already has a lower-cost, "no frills" plan available to people who buy their own insurance. The basic-and-essential plan, offered since 2004, includes a wellness benefit with mammography coverage. It has enrolled nearly 53,000 customers and contributed to the recent decline in the number of New Jersey's uninsured.
New Jersey also already has a program to make mammograms available to women who can't afford them because they are under-insured or uninsured. In 2007, this safety net provided breast-cancer screening for 4,300 low-income women.
In his ads, Corzine has been attacking Christie, suggesting he will roll back women's health protections by allowing out-of-state insurance companies who aren't subject to state regulations to do business in New Jersey.
But most non-New Jersey companies are also required by their respective states to cover mammograms. Only Utah does not mandate such coverage.
To support his argument against Christie, Corzine also says very few states match the level of protection that New Jersey mandates. But the National Conference of State Legislatures finds that New Jersey's mammography mandates are no better than those in most other states.
At least 36 other states cover mammograms for women under 40 as New Jersey does. Although those state rules are always subject to changes, what Corzine is implying is not the case right now.
So while Christie may be exaggerating the benefits of his plan and Corzine may be exaggerating its drawbacks, the driving of the issue by Corzine seems effective among voters ? even though most believe the attack is unfair.
By a ratio of almost 2-to-1, likely voters said Corzine's accusation that Christie wanted "to drop mandated coverage for breast-cancer examinations" was an "unfair attack," not a "legitimate issue," according to a Quinnipiac University poll in mid-October. That was true among women voters, too, with 59 percent labeling it unfair and 34 percent legitimate.
But the governor, after months of trailing Christie, pulled even in early October, based primarily on his growing support among female independent voters, according to the Monmouth University Polling Institute. Among these women, who account for about 15 percent of voters in statewide races, Christie's 28-point lead in August evaporated to a 1-point deficit, the Monmouth poll said.
The mammography tussle knocked Christie off his message and onto the defensive, while giving Corzine a respite from bad economic news and an effective new line of attack.
"While these voters had been giving their soft support to Christie based on discontent with the Corzine economic record, they appear to have beaten a hasty retreat when threats to their health care access were raised," said Patrick Murray, the institute's director.
E-mail: washburn@northjersey.com and reitmeyer@northjersey.com
LOAD-DATE: November 4, 2009
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