Haslam Vetoes Bill To Require Insurance Coverage Of Experimental Cancer Treatment | Nashville Public Radio

Haslam Vetoes Bill To Require Insurance Coverage Of Experimental Cancer Treatment

May 3, 2018

Updated 10 p.m. with reaction from Provision Proton Therapy and legislative leadership.

Gov. Bill Haslam has vetoed a measure that would have required the state's insurance plan to cover an experimental cancer treatment.

Proton therapy promises to pinpoint radiation on the places that require treatment and do less collateral damage on surrounding organs and tissue, but many providers believe it's too costly and unproven.

The skeptics include officials in the Haslam administration who decide what benefits state workers should get. They argued against covering proton therapy for most types of cancer.

So the only company in Tennessee that offers the treatment, besides St. Jude Children's Hospital, went to the state legislature, which pushed through a measure that would have forced the state insurer to provide coverage.

The CEO of Provision Proton Therapy, Tom Welch, sat in committee hearings for multiple weeks until there were enough votes to advance the measure. Once the bill reached the floor in the House and Senate, it passed by a wide margin.

More: Why Tennessee Lawmakers Are Requiring Coverage Of One Experimental Cancer Treatment

Haslam says he's vetoing the bill to discourage such methods of policymaking. He says medical evidence — not political clout — ought to determine what gets covered.

"The state plan currently covers many forms of radiation treatment, and the provider advocating this bill rejected a medically appropriate plan for expanded coverage to instead pursue a political mandate," he said in a written statement. "The state is committed to high-quality care that is medically appropriate and fiscally responsible for patients and taxpayers, but this mandate could put patients at risk and expose them to excessive charges from out-of-network providers."

The state insurance plan covers about 300,000 government workers and teachers. The veto is only Haslam's fifth since taking office in 2011.

The state legislature could easily override the veto, but doing so would require reconvening in a special session.

"We believe it would be premature at this point," House and Senate speakers Beth Harwell and Randy McNally said in a joint statement. "The most prudent course is to wait for gubernatorial action on all legislation passed this session. Only then can we reasonably assess the need for a special session."

Company Disappointed

Provision has one facility in Knoxville and is building another in Franklin, even though the Knoxville treatment center is running at just half capacity. Company officials say they need insurance plans to cover the therapy in order to make their business model work, which includes installing an expensive cyclotron used to generate the targeted radiation.

"We are very disappointed that the governor has vetoed the Proton Therapy Access Bill," CEO Tom Welch wrote in a statement, suggesting Haslam is standing in the way of patients getting state-of-the-art treatment. "This bill was cost-neutral to the state and cancer patients. By vetoing the bill, the governor has deferred his decisions on what’s best for the state insurance members to his third-party vendors, the insurance companies, and taken the decision out of the hands of the patient and their physicians."