The Doubt of the Benefit: Why State Benefit Mandates are a Poor Prescription for Health Insurance

A benefit mandate is a state law that commands a health plan to pay for, or at least offer, a specified treatment or type of provider, removing the benefit from negotiation between beneficiaries and health plans. For example, a mandate may require a health plan to cover treatment of alcoholism, or chiropractic services.

In 2007, there were 84 separate benefit mandates in force in at least three states. In total, there were 1,594 state laws, averaging out to 32 mandates per state. This marks a significant increase from 1979, when 252 mandate laws were in force—an average of only five per state. The pace has now picked up again. Among the benefit mandates introduced since 2000 are: hearing aids, hormone replacement therapy, and reimbursement for clinical trial participation. In 2007, soon after it was introduced, 13 states mandated coverage for the human papillomavirus vaccine.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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