State medical insurance mandates increase in 2011

By Maryalene LaPonsie on May 2nd, 2012

States added 106 mandated services to health insurance plans in 2011, according to an analysis published last month. The number was calculated by the Council for Affordable Health Insurance, an advocacy group that says medical insurance mandates are costly and can lead to higher health insurance rates.

The number of mandates has been steadily increasing since CAHI first began compiling nationwide data in 2004. In that year, the number of medical insurance mandates totaled 1,823. By 2011, that figure had grown to 2,262.

By CAHI's definition, a mandate is a requirement that health insurance plans and companies cover or offer coverage for a particular health care provider, patient population or benefit. The group asserts these requirements have the potential to significantly increase medical insurance costs.

From mammograms to implant removal

State mandates for health insurance plans cover a broad range of services. Mammography screenings and minimum maternity stays are mandated in all 50 states. Breast reconstruction and mental health parity mandates have been issued in 49 and 48 states, respectively.

Less popular mandates include those for breast implant removal, circumcision and gastric electrical stimulation. All of these are examples of mandates required of health insurance plans in only one state each.

Saying mandates "spread like a river overflowing its banks," CAHI argues states often pass mandate legislation in response to other states' regulations or under pressure from special interest groups. The organization notes there currently appears to be a trend in passing mandates in the following areas:

  • Autism
  • Oral and infusion chemotherapy
  • Diabetes
  • Preventive screenings

States with the most and least mandates

While every state has mandates, there is a significant gap between states with the greatest and least number of medical insurance requirements. The five states with the most mandates are:

  1. Rhode Island - 70
  2. Virginia - 70
  3. Maryland - 67
  4. Minnesota - 65
  5. Connecticut - 63

Meanwhile, the states with the fewest mandates are:

  1. Idaho - 13
  2. Alabama - 19
  3. Michigan - 23
  4. Hawaii - 24
  5. Utah - 26

In addition, CAHI reports 10 states allow insurers to sell "mandate-lite" health insurance plans. These policies allow individuals to opt out of some mandated coverages. That may result in more affordable health insurance options. The CAHI analysis also notes 30 states now require the cost of a mandate be assessed prior to its implementation.

Maryalene LaPonsie
Maryalene LaPonsie has been writing professionally for more than a decade on topics including education, insurance and personal finance. She holds a Bachelor's Degree in Political Science from Western Michigan University.

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