PRI released a new paper today, which examines one critical area where states interfere in residents' ability to buy health insurance of their choosing. According to From Heart Transplants to Hairpieces: The Questionable Benefits of State Benefit Mandates for Health Insurance, benefit mandates increase health insurance premiums, reduce wages, increase working hours for employees, and deprive some workers of health benefits altogether.

In 2007, there were 1,594 state mandates, averaging 32 mandates per state. This marks a significant increase from 1979, when there were just 252 mandate laws in force – an average of only five per state. Among the benefit mandates introduced since 2000 are: hearing aids, hormone replacement therapy, and reimbursement for clinical trial participation.

In California alone, 10 new benefit mandate bills being considered in the legislature would cost Californians $2.7 billion in the first year in the form of premium increases for private plans and taxpayer funding for CalPERS (the public employees’ benefit fund) and MediCal (Medicaid). This is a potential increase of 3.6 percent in California’s health care costs according to the California Health Benefits Review Program.

Clearly, state mandates are on the rise. Lawmakers, with the best of intentions, want to assure that their constituents get access to care. Unfortunately, these benefit mandates are adding to the problem of the uninsured. The design of health insurance is far too complex to be done by politicians. Decades of experience with benefit mandates have shown that they are expensive, and do not improve access to care. It is prudent that politicians should exercise restraint in establishing mandated benefits, and let employers, individuals, and health plans spend health care dollars on health care that they decide is beneficial, not health care that politicians favor.