PHOENIX - Gov. Jan Brewer vetoed legislation Friday that would have allowed individuals to shop around for the best price on health-care needs, saying there are technical problems with the proposal.
The legislation by Sen. Nancy Barto, R-Phoenix, would have put hospitals and doctors in the same position as retailers: They would have to give customers an opportunity to learn what certain procedures will cost before they show up in a waiting room.
That would have included both a requirement for online posting and making a price list available on-site.
Barto promoted the legislation as a cost-containment measure, especially for patients without comprehensive health insurance who end up having to pay all or part of their medical bills.
In her veto, the third of the legislative session, Brewer said she supports providing more "useful information to help patients manage their health-care needs." But the governor said there are "practical and potential legal implications of this bill."
Barto called the veto "an incredible insult to consumers."
The senator said she had been in contact with the Governor's Office and had not heard any objections until now. Barto said she would have made necessary changes had Brewer's staff raised issues before final approval - and before it was too late in the legislative session to start over.
Barto said it may be that Brewer's veto has less to do with the text of the legislation than the fact she has been an outspoken foe of the governor's push to expand the state Medicaid program.
"It's not to her benefit to play those games," Barto said of the governor. "She's not going to gain votes by being petty."
Gubernatorial press aide Matthew Benson said the veto is totally unrelated to Barto's opposition to the Medicaid plan. He said there were "technical concerns."
Among those, Benson said, is that hospitals do not have one flat rate they charge for procedures. He said different charges apply depending on whether the patient is paying his or her own bill, has coverage from an insurance company that has negotiated a discount or is a Medicaid patient.
"If they're making that case, they're misrepresenting the bill," Barto responded.
"We're asking them to provide the price for health care when you pay without a third party," she said, meaning those without insurance. "That's the price nobody wants to admit that they want out there because it's going to enable and empower consumers to compare prices. That's why the hospitals are fighting it."
Barto said this is important, and not only for the approximately one out of every six Arizonans without some form of insurance.
She said 53 percent of employers who do provide insurance are offering "high deductible" plans, meaning the workers and their families are responsible for large out-of-pocket costs. "And it's going to climb to 67 percent next year," Barto said.
Benson said there were other issues. For example, the measure would have affected not only regular hospitals but also facilities run by the Veterans Administration, the Indian Health Service, tribal clinics, military hospitals and the Arizona State Hospital. He said these do not serve the general public and should be exempt.
In her veto message, Brewer said the bill "contains a number of ambiguous terms and definitions that likely would cause unnecessary litigation and create conflict with both state and federal law," though she provided no specifics. And she said - again without providing details in her veto - the legislation could impede the ability of the Arizona Medical Board to effectively investigate complaints and discipline doctors for billing abuses and excessive fees.
Barto said these are simply excuses irrelevant to the underlying issue of transparency.
Benson said Brewer is willing to work with Barto to find an acceptable plan, but next year.
Barto has also been at odds with the governor and hospitals over their contention they need Brewer's Medicaid expansion to stop losses from uncompensated care.