Joe Pyrah

In the shadow of promised health care reform, in the face of unwilling lawmakers and in defiance of the insurance industry is Tami Stanley's leg.

The carbon fiber and steel prosthetic was on display Wednesday, firmly attached to the Orem resident's knee as she pleaded with members of the House Business and Labor Committee to approve a health insurance mandate to help amputees.

"Everyone assumes it would be covered," she said afterward of artificial limbs. "There's no way the insurance companies cannot meet the needs of their customers."

The insurance coverage for prosthetics vary, but often it maxes out at one limb per lifetime or $2,500 a year, which may sound like a lot but isn't when talking about limbs that cost tens of thousands of dollars.

Stanley and bill sponsor Rep. David Litvack, D-Salt Lake City, want the state to mandate that insurance companies cover costs equal to Medicare, which is 80 percent with no cap.

The cost to consumers is estimated at an additional $2 per year, Litvack said, and he argues that the long-term savings would easily make up for that and more. That's because those who can't afford prosthetics typically quit their jobs, go on disability and become a burden of the state.

Insurance companies, however, don't like the idea of any mandate and say the bill will only reach about 39 percent of the insured.

"I don't know whether I should introduce myself as the Grinch or Scrooge," quipped Kelly Atkinson, executive director of the Utah Health Insurance Association. "It should not go forward because it does not treat everyone in the marketplace equally."

That's because the government is exempt from mandates and big businesses typically insure themselves and are also exempt. Some of that is perhaps disingenuous, as the bill calls for a match of the government standard, so the fact it is exempt is moot.

Rep. Mike Morley, R-Spanish Fork, was concerned that in the face of the proposed health care reform on a statewide level to make it more affordable, throwing mandates around may be premature.

"If we start mandating that every policy needs to carry certain criteria ... are we not starting to create a policy again that because it is so expensive it becomes prohibitive?" he said.

Rep. Steve Clark, R-Provo, suggested that Litvack and Stanley try and get together with the insurance companies to work something out. It was an idea that Stanley could later only shake her head at. She has been to the insurance companies, as has Litvack, with little to show for their efforts.

The committee eventually voted 10-2 to move on without taking action, which is typically done when they disapprove of the bill.

Afterward, Stanley and other proponents circled in the hallway where she assured them the bill would be coming back next year.