Alcohol Exclusion Law: The Case for Repeal

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Alcohol Exclusion LawThe Case for Repeal

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• Presentation to ltOrganizationgt
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Scope of the Problem

• Alcohol-related traffic crashes are a leading
  cause of death, injury, and expense
• 17,000 dead
• 500,000 injured
• 16 billion in property damage
• 40 - 60 of injured patients in trauma centers
  have positive blood alcohol levels
• 80 screen positive for alcohol use disorder.

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Alcohol Exclusion Law What It Is

• 1947 Alcohol Exclusion Law embedded in model
  Uniform Accident and Sickness Policy Provision
  Law (UPPL)
• Allows insurers to deny coverage to individuals
  injured as a result of being under the influence
  of alcohol or narcotics

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Alcohol Exclusion Law History

• Model Law
• National Association of Insurance Commissioners
  (NAIC), 1947
• Widespread Adoption
• Most states adopted during the 1950s
• Model Repeal Law
• NAIC, 2001
• State Prohibition Efforts
• 9 states have prohibited exclusions

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Alcohol Exclusion Law Status State-by-State

• Prohibited Iowa (2002), Maryland (2001), Nevada
  (2005), North Carolina (2001), Rhode Island
  (2005), Vermont (2002), Washington (2004),
  Colorado (2006), Connecticut (2006), District of
  Columbia (2007)
• Still in Force 36 states
• Never Adopted Massachusetts, Michigan, New
  Mexico, New Hampshire, Utah, Wisconsin

Courts have ruled that insurance companies can
use alcohol/drug exclusions in states that are
silent on Alcohol Exclusion Law
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AEL Status State-by-State
Implicit allowance
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Ensuring Solutions to Alcohol Problems
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Alcohol Exclusion Laws Unintended Consequences

• Threatens public health
• Discourages alcohol screening and treatment
• Contributes to drunk driving injuries and
  fatalities
• Increases costs
• Part of 19 billion annual bill for
  alcohol-related health care costs
• Impedes law enforcement
• Allows drunk drivers to escape detection
• Inhibits identification of people with alcohol
  problems before they drive drunk

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Benefits of Repeal

• Increase alcohol detection and treatment
• 28 fewer drinks per week
• 48 reduction in hospital readmissions
• 3.81 return for each 1 invested in intervention
• Improve public safety
• Increase detection of drunk drivers
• Reduce repeat drunk driving
• Reduce crashes

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AMA Supports Repeal

• In 2003, the American Medical Association (AMA)
  adopted a resolution in support of repeal
• RESOLVED, that our American Medical Association
  support state and specialty medical societies and
  the public heath associations in their efforts to
  secure repeal of laws and state insurance codes
  which allow for the denial of insurance payments
  for the treatment of injuries sustained as a
  consequence of the insured person being
  intoxicated due to alcohol or under the influence
  of narcotics.

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MADD Supports Repeal

• Mothers Against Drunk Driving (MADD) has endorsed
  repeal in an Official Position Statement
• MADD supports the removal of exclusionary
  coverage provisions which provide any barrier to
  medical or drug and alcohol treatment in health
  insurance policies and the elimination of
  sections of state laws and regulatory policies
  that allow such exclusions.

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Widespread Support for Repeal

• NAIC, which drafted model Alcohol Exclusion Law
  in 1947, voted unanimously to recommend
  prohibition of exclusions (2001)
• National Conference of Insurance Legislators
  recommended repeal (2001)
• Other repeal supporters include
• American College of Emergency Physicians
• American Public Health Association
• American Bar Association
• Council of State Governments
• American College of Surgeons

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Possible Repeal Efforts in 2007
WASHINGTON
NORTH
MAINE
MONTANA
MINNESOTA
DAKOTA
VT
OREGON
NH
WISCONSIN
MASS
SOUTH
IDAHO
DAKOTA
NEW YORK
MICHIGAN
WYOMING
RI
CONN
IOWA
PENN
NEW
NEBRASKA
JERSEY
NEVADA
OHIO
DELAWARE
INDIANA
UTAH
ILLINOIS
COLORADO
MARYLAND
WV
KANSAS
VIRGINIA
MISSOURI
KENTUCKY
CALIFORNIA
NORTH
CAROLINA
TENNESSEE
ARIZONA
ARKANSAS
OKLAHOMA
SOUTH
CAROLINA
NEW MEXICO
MISS
GEORGIA
ALABAMA
TEXAS
FLORIDA
LOUISIANA
ALASKA
HAWAII
States in play, 2007
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For More Information

• Alcohol Exclusion Law Toolkit
• www.ensuringsolutions.org (under Resources)
• Sign up for AEL-related Alerts
• Click on Subscribe to Our E-Newsletter at the
  top of the Ensuring Solutions homepage
  (www.ensuringsolutions.org). Choose the
  Treatment newsletter.
• Contact David Anderson at Ensuring Solutions
• danderso_at_gwu.edu
• 202-530-2321