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Health Care / Free-Market Reform

Missouri’s Many Health Insurance Mandates

By Caitlin Hartsell on Jun 15, 2010

In the recent public discussion of the autism bill and health insurance mandates, a recurring question has emerged: can a particular mandate be worth the costs — or, at least, be more worthy than most? If we follow that logic, though, where do we draw the line?

As of 2009, Missouri had 41 mandates for health insurance. Considered singly, no individual mandate had a large impact on premium costs, but they each had a marginal impact. Every incremental increase in the cost of health insurance premiums leads to the possibility that some unknown number of individuals and businesses are no longer able to afford their previous coverage.

Here is a look at mandates in Missouri (data compiled from the Council for Affordable Health Insurance):

Mandated benefits: States with mandateInfluence on premium
Alcoholism/Substance Abuse451% to 3%
Ambulatory Surgery111% to 3%
Blood Lead Poisoning Screening9<1%
Bone Marrow Transplant11<1%
Bone Mass Measurement16<1%
Breast Reconstruction50<1%
Cervical Cancer/HPV Screening31<1%
Clinical Trial23<1%
Colorectal Cancer Screening33<1%
Contraceptive291% to 3%
Dental Anesthesia30<1%
Diabetic Supplies47<1%
Drug Abuse Treatment35<1%
Emergency Service47<1%
Hair Prothesis11<1%
Mammography50<1%
Mastectomy23<1%
Mastectomy Minimum Stay25<1%
Maternity231% to 3%
Maternity Minimum Stay50<1%
Mental Health General391% to 3%
Mental Health Parity475% to 10%
Newborn Hearing Screening18<1%
Off Label Drug Use36<1%
PKU/Metabolic Disorders34<1%
Port Wine Stain Elimination2<1%
Prostate Cancer Screening36<1%
Second Surgical Opinion11<1%
Well Child Care341% to 3%
Mandated providers: States with mandateInfluence on premium
Chiropractor461% to 3%
Dentist343% to 5%
Nurse Practitioner31<1%
Optometrist44<1%
Podiatrist33<1%
Psychologist441% to 3%
Speech/Hearing Therapist21<1%
Mandated coverage: States with mandateInfluence on premium
Continuation Dependent43<1%
Continuation Employee45<1%
Conversion to Non Group421% to 3%
Dependent Student/Adult34<1%
Disabled Dependent421% to 3%
Newborn511% to 3%

As we’ve discussed before here at Show-Me Daily, injecting competition into the insurance market is really the only long-term solution that will both increase coverage and lower health care costs. Sarah Brodsky has also suggested tuition tax credits for autistic children as another alternative to insurance mandates.

Regardless of how one looks at the issue, mandates do not serve as a solution. The list provided by CAHI contained 130 different mandates throughout all of the states and Washington, D.C. Health insurance would be prohibitively expensive for far more people if every policy had to cover all 130 items, and there will still be many other conditions or diseases that are not covered. Does every 20-year-old want insurance against Alzheimer’s disease? Does every 60-year-old want insurance against autism?

With more choice in the insurance market, people can better choose for which illnesses or conditions they wish to be insured. Eliminating the way in which insurance is tied to employment and encouraging health savings accounts would allow individuals to purchase portable, cost-effective policies, saving for foreseeable health-related expenses while hedging against unknown future risk.

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About the author

Caitlin Hartsell

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