Health Insurance Mandates Put Pressure on Prices

Oklahoma health insurance mandated policies covers everything from chiropractors to psychologists.
Health insurance mandates are state laws requiring the inclusion of specific coverage in health insurance policies.
Other mandated insurance policies in Oklahoma cover dentists, nurse midwives, optometrists, osteopaths, podiatrists, speech or hearing therapists as well as coverage for adopted children, continuation coverage for dependents, continuation coverage for employees and coverage for newborns.
There are 36 health insurance mandates in Oklahoma, according to the Council for Affordable Health Insurance report published earlier this year. Information was based on 2006 laws. Since mandate change frequently, it is possible that the state’s health insurance mandates have changed.
The most recent trend in mandates is to avoid calling them “mandated coverage,” said Kimberly Morris, OnlineAdviser service manager for MedSave.
“Mandated coverage developed a bad public image as an increasing number of people become aware of the costs these were adding to everyone’s health insurance,” she said.
Studies performed by health insurers who have assessed the cost of mandates on their policies report that when a mandate becomes law, it costs money.
Estimates vary, but on average an Oklahoma resident can expect that 15 cents of every dollar they spend on health insurance goes to benefit a relatively few people — a “special interest group” — and do not benefit the vast majority of those who pay for health coverage, Morris said.
“As overall health care costs continue rise to the point where the average person/employer cannot afford it, this became a heated issue,” she said.

That was the case this past spring in the Oklahoma Legislature.
During the session, state Rep. Ron Peterson, R-Broken Arrow, became the target of heavy criticism from supporters of a measure that would require health insurers to cover behavioral and other treatments for autistic children. This sort of coverage is provided in a number of other states, including Texas.
After dying in Peterson’s committee, it was resurrected in the Senate and sent back to the House, where supporters said it would pass if given a hearing on the House floor. But the bill died from lack of support.
Also, a State Chamber of Commerce memo to members of the Oklahoma State Legislature exaggerated the cost of legislative mandates for insurance coverage, said state Sen. Andrew Rice, D-Oklahoma City.
The “truest statement in the memo” is that the cost of health insurance continues to spiral upward, Rice said. “However, the Chamber offers no proof that insurance mandates are among the reasons why.”
Rice was Senate co-author of “Steffanie’s Law,” legislation that would have required private insurance companies in Oklahoma to continue coverage of routine medical care costs even after a cancer patient enrolls in experimental clinical trials. The bill was inspired by the late Steffanie Collings, who recently died at the age of 18 after fighting brain cancer for four years.
Rice gained passage of Steffanie’s Law in the State Senate but the bill remained blocked in the House.

The mean number of health insurance mandates for all of the states is 38.
Laws vary from state to state and are sometimes referred to under different terminology but have the same effect. Mandates make health insurance more comprehensive but also raise the cost of health insurance. Some types of health insurance including short term medical insurance, supplemental insurance and international travel insurance are exempt from many state mandates and are therefore able to keep premium costs lower.
Each of these individual mandated coverage items accounts for less than 1 percent of the total cost of insurance with the exception of coverage for dentists, which accounts for 3 percent to 5 percent of the total cost of insurance, according to the council report.
Most major medical health insurance policies contain a provision in the contract that specifies that they will cover state mandated benefits regardless of the specific wording in their policy. Major health insurance companies typically provide benefits in addition to those required by state law.

While mandates make health insurance more comprehensive, they also make it more expensive because mandate require insurers to pay for care consumers previously funded our of their own pockets, according to Victoria Bunce, director of Research and Policy for the Council for Affordable Health Insurance.
“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,” Bunce said.
This article is meant to provide general information. See your own policy for specifics about your own coverage. ?



Was this article helpful?

Related Articles

Leave A Comment?