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Health Insurance Mandates in the States 2008

August 4, 2008
By Victoria Craig Bunce and JP Wieske

The Impact of Mandates. While mandates make health insurance more comprehensive, they also make it more expensive because mandates require insurers to pay for care consumers previously funded out of their own pockets.

stethoscope and insurance docs

The Impact of Mandates. While mandates make health insurance more comprehensive, they also make it more expensive because mandates require insurers to pay for care consumers previously funded out of their own pockets. We estimate that mandated benefits currently increase the cost of basic health coverage from a little less than 20% to more than 50%, depending on the state and its mandates. Mandating benefits is like saying to someone in the market for a new car, if you can’t afford a Cadillac loaded with options, you have to walk. Having that Cadillac would be nice, as would having a health insurance policy that covers everything one might want. But drivers with less money can find many other affordable car options;whereas when the price of health insurance soars, few other options exist.

Why Is the Number of Mandates Growing? Elected representatives find it difficult to oppose any legislation that promises enhanced care to potentially motivated voters. The sponsors of mandates know this fact of political life. As a result, government interference in and control of the health care system is steadily increasing. So too is the cost of health insurance.

How Is the Research Compiled? Since 1992, the Council for Affordable Health Insurance staff has tracked the introduction and passage of individual and small group market (i.e. not HMOs, PPOs, or the self-funded large group market) health insurance mandates in every state, but not until 2004 did we make this information available to the public. To corroborate our own findings, we survey every department of insurance and talk with other industry experts.

Mandates and Standard Coverage. Just because we list something as a mandate doesn’t necessarily mean it should be excluded from a standard health insurance policy. Many mandates listed here should be and often are included in comprehensive coverage. The purpose of this chart is to tabulate the number of benefits mandated by the states and assess their impact on the cost of insurance — not to make judgments about which mandates should or should not be included in a health insurance policy.

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