Time to protect all Missourians from denials of insurance coverage

To the editor:

Missouri legislators are now focusing on the importance of making English the official language of Missouri so “government decisions are not made in another language” and ” for the public good.”

As long as they are so interested in protecting the public good — they need to be aware that government decisions are already being made in the language of the insurance industry.

The Proposed Health Net Plan also does not promote the public good by continuing to deny benefits in light of a budget surplus.

Over 90,000 people have been denied their benefits in the past two years. Those who will continue coverage by the proposed Health Net Plan may have their care coordinated by persons who may not be their physician or nurse practitioner.

I am a community health nurse and perform follow-up visits in the home for prenatal and postpartum patients. I deal with the language barriers caused by health-care insurance plans on a daily basis.

For example — an unemployed pregnant woman who had one prenatal visit and a confirming ultrasound was denied Medicaid.

She had applied for Medicaid as soon as she thought she was pregnant. Her Temporary Medicaid status had allowed the first visit and ultrasound.

She was given a prescription for medication that would help treat an infection that would complicate the pregnancy. She couldn’t fill it because Medicaid canceled her coverage. Her Medicaid application did not show proof of pregnancy. The physician had to be re-contacted and the application had to be reprocessed. This not only took time, but delayed ordered treatments.

I visited a 29-week high-risk pregnancy patient who is currently “covered.” She had a written prescription for anti-embolism stockings that her insurance denied to cover.

The physician had to be re-contacted to rewrite the prescription according to her diagnosis “code” even though her diagnosis code already covered her twice daily injected anti-coagulant medications to prevent an embolism.

These conflicting denials of coverage for ordered services forces the health-care professional to work on the phone instead of working with patients. Nurses would make greater use of their time with patients if they didn’t have to deal with the denials and other barriers caused by the language of insurance plans. It definitely is contorting, dictating public policy and needs to be abolished for the public good.

Considering the Missouri budget is in surplus, funds could be restored to those 90,000 Missouri citizens who are denied coverage and legislators need to work toward health-care coverage for all Missourians.

State legislators wanting to spend our tax dollars to make a constitutional amendment for “the public good” have the opportunity to go beyond a “feel-good” resolution to save the English language in Missouri.

The state motto, “Let the Welfare of the People be the Supreme Law,” is carved into the Capital wall. It needs to be carved into legislation that protects all Missourians from the denials of coverage dictated by insurance plans.

Jan Polizzi, RN, MS


Editor’s note: Jan Polizzi is a former state representative and former Mehlville Board of Education member who currently serves as president of the Missouri Nurses Association.