Gregoire signs organ transplant cap into law, despite last-minute concerns

A bill to beef up insurance coverage for organ transplants was signed into law Thursday by Gov. Chris Gregoire, having overcome a last-minute amendment that had made critics out of its original supporters.

The signing of Senate Bill 5725 will raise the minimum lifetime transplant coverage to $350,000, from $250,000 in most cases.

In Washington, health insurers are not required to cover organ transplants, though most do. Benefits range from $200,000 to unlimited, with insurers typically capping them at $250,000.

Beginning Jan. 1, all policies sold or renewed from that date that include transplant coverage must provide at least $350,000 in coverage.

Transplants are the only major medical procedures that are subject to a separate cap on benefits.

The bill's expected passage hit a snag last month after Rep. Eileen Cody, D-Seattle, inserted an amendment at the behest of Premera Blue Cross and other insurers.

The bill's supporters, including John Scanlon, a heart-transplant recipient from Kent, initially concluded that the new language could in some cases lessen, not increase, transplant coverage.

The amendment specified that transplant coverage for some patients could start as early as the date of hospitalization. Supporters of the bill feared that would exhaust benefits more quickly if a patient were hospitalized well before a transplant.

Premera argued that critics of the amendment were misinterpreting it. The company also assured lawmakers that the amendment's intent was not to penalize long-term hospital patients.

Mike Kreidler, state insurance commissioner, backed the insurers. In a letter to Gregoire, Kreidler said he expects insurers to honor the spirit of their pledge and that his staff would be monitoring their actions closely for compliance.

Scanlon, 60, said he eventually accepted the amendment despite his skepticism about the insurers' intent.

Kyung Song: 206-464-2423 or ksong@seattletimes.com