(reprint 2)

by peter5427

SB233 is a deeply flawed bill because it commits serious legal and ethical errors.

1. SB233 contains unfunded mandates.

This is nonsense. This is irresponsible. Who will pay for its consequences? Not I, said the little pigs in Congress. Not I, said the little pigs in the Legislature. Then WHO?

2. SB233 writes into Nevada law certain 0bamacare mandates.

This is nonsense. 0bamacare is being REPLACED, sooner or later, as soon as those incompetent congressional Republicans manage to get their act together. If SB233  becomes law, will the legislature wait till 2019 to readjust the NRS accordingly, or will the Governor call a special session to do so?

3. SB233 supersedes a doctor’s professional judgement about patient care by imposing legal mandates.

SB233 (and the “ACA,” more correctly known as 0bamacare) actually DICTATES TO THE DOCTOR what he must do for a specific patient whom he has not yet seen and whom the Legislature has no interest in ever seeing themselves. Medical diagnosis by LAWYERS and law makers? This is pure nonsense. This is exceedingly egregious.

Examples, from the Legislative Counsel’s Digest:

Line 25
Sections 7, 8 and 11-57 of this bill allow an insurer to require an insured to pay a  higher deductible, copayment or coinsurance for a drug for contraception if the  insured refused to accept a therapeutic equivalent of the contraceptive drug.

Line 31
authorize an insurer to use  medical management techniques, including step therapy and prior authorization, to determine the frequency of the preventative services required by this bill or the type of provider of health care who will provide such services.

It is up to the patient and her doctor to decide what care is appropriate for that particular patient, and who will provide that care — not the FDA, insurer, the feds, or the legislature.

Line 39
Sections 12, 18, 27, 33, 38, 45 and 54: (1) prohibit the use of medical management  techniques to require an insured to use a method of contraception other than that  prescribed or ordered by a provider of health care;

“Medical management techniques” is just another way of saying that it will be the government and the insurers who decide what the doctor can prescribe or administer as the proper care for his patient.

And now we also see that SB233 contains an internal inconsistency. The two list of sections cited above contradict each other. Which one will override the other? Well,… that will be decided by the regulators and the courts… of course.

Line 48
Sections 12, 20, 27,  33, 38, 45 and 54 of this bill move the religious exemption to the new provisions relating to coverage of contraception.

THIS flies directly in the face of the First Amendment…!!! A silly bill by a silly majority in a state legislature cannot override the US CONSTITUTION…!!!

Line 56
Sections 7, 8 and 11-57 of this bill expand this  requirement  [ to include coverage for hormone replacement therapy ]  to  provide coverage for hormone replacement therapy without any copay, coinsurance or higher deductible.

These are just code words for the current fad of sex reassignment procedures at tax payer expense. Most women are no longer treated with hormone replacement therapy during menopause.

Line 80
Section 8.5 of this bill requires a pharmacist to dispense up to a 12-month or the balance of the plan year, whichever is shorter, supply of contraceptives or their therapeutic equivalent

The legislature can require no such thing. It is up to the doctor to decide, based on his examination of and regular follow-up with the patient, what the proper course of action is for that particular patient.

Line 61
Existing law requires this State to develop a State Plan for Medicaid which  includes, without limitation, a list of the medical services provided to Medicaid recipients.

First of all, constitutionally the feds can require no such thing. It is the 9th and 10th Amendments that give States that authority.

Accordingly, I suggest that the Legislature fulfill this requirement by rewriting this bill so a doctor is formally authorized to use his best professional judgement regarding the proper care of his patient. Anything else is just a fascist intrusion into the most intimate details of the relationship between a patient and her doctor.