Mandating health insurance

However, the federal govern-ment's new mandates - banning "drive-through" baby deliveries and requiring that any cap on mental health benefits be the same as the cap on physical health benefits - apply to all insurance.

Moreover, Congress appears likely to pass even more mandates in the future.

Consumer Operated and Oriented Plan Programs (COOPs) were really a political compromise between Members of Congress who wanted a public plan option and those who didn’t.

Once the Affordable Care Act passed, COOPs had outlived their usefulness.

A new analysis prepared for the National Center for Policy Analysis by the actuarial firm Milliman & Robertson estimates the costs of 12 of the most common mandates and finds that, collectively, they can increase the cost of insurance by as much as 30 percent. Although there were only seven state-mandated benefits in 1965, there are nearly 1,000 today.

Known as mandated health insurance benefit laws, they force insurers, employers and managed care companies to cover - or at least offer - specific providers or procedures not usually included in basic health care plans.

How Much Do Mandates Increase the Cost of Health Insurance?

The Milliman & Robertson analysis of 12 of the most common mandates is based on policies in a representative state.

The law may say that the mandate only applies to large group plans, for example, or that it doesn’t apply to any plans that are required to provide the essential health benefits. “Your state has passed a law but everything is so market specific it’s hard to know what coverage you’re getting,” says Katie Keith, research director at the Trimpa Group, a consultant for autism and other advocacy groups.

A state may say that if the mandate increases premiums by a certain percentage the provision doesn’t apply. Although some states are trying to sidestep having to pay for new mandates by limiting which plans are included, advocates say uncertainty about who is going to have to foot the bill is having a chilling effect overall.

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