Legislature passes bill to expand children’s health care

The Senate passed HB 2153 on March 6, a bill guaranteeing that insurance companies cover the elemental formula necessary to feed children who suffer from a rare gastrointestinal disorder. The bill was sponsored by Rep. Cyrus Habib (48th Legislative District), D-Kirkland, and was a companion bill to legislation introduced in the Senate by Sen. David Frockt, D-Seattle.

“When people pay for health insurance, it’s reasonable for them to expect that their insurance will pay for treatment that their child needs to survive,” said Frockt. “This is a basic protection. Medicaid covers it; private insurance should cover it as well. It’s only fair.”

Eosinophilia gastrointestinal disorders are very rare. Those who suffer from the disorder are unable to breakdown proteins, meaning they must take proteins through a special elemental formula. If the treatment is delivered through an invasive feeding tube, the expensive formula is covered by insurance. However, if the patient can swallow the formula, many private insurers will not cover the cost.

The treatment costs approximately $1,200 per month and many families have great difficulty covering the out-of-pocket cost for the treatment. Mandating insurance coverage would help those families afford life-saving treatment for their children.

“There are low-income people who are covered by Medicaid, and they have this treatment covered by their insurance, and there are people who are well-off and can afford the cost out-of-pocket,” said Habib. “We can’t forget about the people in the middle who need their insurance plan to be there for them when their children need life-saving treatment.”

The bill would require that health benefit plans must offer benefits or coverage for medically necessary elemental formula, regardless of delivery method, when a licensed health care provider diagnoses a patient with eosinophilia gastrointestinal disorders and supervises the use of the elemental formula.

The bill will now move onto Gov. Jay Inslee's desk for signature to become law.


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