Coverage mandates: “We’ll tell you what you need”

National Center for Policy Analysis
December 16, 2009

Insurance coverage mandates refer to the restrictions each state sets on which type of policy can be sold legally within that market. For example, fourteen states now require all insurance plans sold to cover infertility treatments, regardless of the patient’s need or desire for these services. Other states ban the sale of insurance plans unless they include coverage for massage therapy, obesity surgery, pastoral care, and wigs.

Needle-phobic consumers cannot buy plans without acupuncture coverage, and teetotalers must pay for plans that include inpatient drug rehabilitation, says Dr. Linda Halderman, a General Surgeon and policy adviser in the California State Senate.

What effect do mandates have on the cost of health insurance?

* According to the National Center for Policy Analysis, just 12 of the most common insurance mandates currently in place raise premium rates by as much as 30 percent.

* The State of California forces over 50 such mandates on the employer-provided (group) insurance market, but not on individual plans; consequently, it costs three times more for California employers to offer insurance than if a plan is privately purchased.

In mandate-heavy states, consumers are denied the option of buying low-cost, basic health insurance plans to cover major illness or injury. They cannot choose to save money by paying out of pocket for ten-dollar pneumococcus pneumonia vaccines and ninety-dollar mammograms, thereby reserving health insurance for significant expenses, explains Halderman.

In those states, insurance is not insurance at all — it is expensive, prepaid health care. In other words, when Hummers and Ferraris are the only vehicles sold, people on Toyota budgets can’t afford transportation, says Halderman.

Source: Linda Halderman, “Senate’s Solution: Consumer Choice Is Dead on Arrival,” American Thinkers, December 16, 2009.

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