screen-shot-2018-04-11-at-8-16-41-am-221x300-7645711As the legislative session heads into its closing weeks, it’s time to update Mandate Watch, the Empire Center’s tally of bills that would impose additional coverage requirements—and costs—on health plans.

The goal is to raise awareness of an expensive habit in Albany: passing insurance mandates without thinking through the consequences.

Most such bills mandate coverage for services that go beyond the evidence-based recommendations of medical societies and other experts—and might therefore encourage unnecessary or wasteful care. Almost all would tend to push up premiums that are already among the highest in the country. None has been subjected to rigorous cost-benefit analysis.

Since most large employers are self-insured, and therefore exempt from state regulation under federal law, mandates mostly affect the small-group and non-group markets—where buyers are more likely to drop coverage if premiums grow too quickly.

Our latest search of pending legislation, summarized here, turned up 120 proposals for new insurance mandates. That’s up 29, or almost one-third, since Mandate Watch was inaugurated in March 2017.

Most are one-house bills with little chance of becoming law. But six have passed the Assembly this year, and 25 have majority sponsors in both houses.

One of the more consequential bills—and probably the most expensive—is A. 2646 (Simotas)/S. 3148 (Savino), mandating coverage of in vitro fertilization (previously discussed in detail here). A similar law in Massachusetts adds an estimated $200 a year to the average cost of coverage for a family of four.

Other proposals include:

Some of these bills exceed mainstream guidelines. The American Cancer Society, for example, recommends mammograms for women at average risk starting at age 45, and says they should be optional at age 40.

The U.S. Preventive Services Task Force, meanwhile, urges biennial mammograms starting at age 50, and says they should be discretionary for women in their 40s.

By ignoring such guidelines, lawmakers run the risk of promoting unnecessary or even harmful procedures—and driving up premiums in the bargain.

To avoid such possibilities, the Legislature in 2007 voted to establish a commission to study the costs and benefits of proposed mandates before enacting them. Unfortunately, the officials responsible for appointing members of the panel never followed through, and Governor Cuomo vetoed its unused funding last year.

Looking to revive that good idea is Assemblyman Clifford Crouch (R-Bainbridge). He is sponsoring A. 2230, which would establish a Health Benefit and Cost Commission to review both existing mandates and new proposals.

“Many of the benefits mandated have served to ensure that people have access to care that they need, but this mandated coverage has also resulted in premium increases,” the sponsor’s memo says. “It is the sponsors’ belief that the Legislature and the public should have cost and benefit analysis before deciding whether to require all policies to include a certain benefit.”

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

A Federal Emergency Rule Is Inflating New York’s Medicaid Enrollment

Strings attached to federal coronavirus relief funding appear to be inflating New York's Medicaid enrollment – and costs – at a time when the state faces unprecedented deficits. Read More

The CDC’s Nursing Home Death Count Is Even Less Complete Than New York’s

The result is that a major public health disaster affecting New York's nursing home residents is not being accurately documented by either of the agencies responsible for protecting them – because state officials are refusing to share the true numbers, and federal officials haven't yet asked for them. Read More

The DOJ’s Probe of Coronavirus in Nursing Homes Appears to Leave Out Most Victims

The U.S. Justice Department's newly announced inquiry into coronavirus in New York's nursing homes comes with a crucial caveat: It will look only at government-operated facilities, which represent a small fraction of the state's nursing-home industry. Read More

State’s Per-Recipient Medicaid Spending Rises to 3rd Highest in the U.S.

New York's per-recipient Medicaid spending has soared to the nation's third highest rate, a sign of fiscal trouble for one of the state's most important programs. Read More

New York Medicaid Spending Is Projected to Jump 6% in Fiscal Year 2021 (UPDATED)

Despite a round of cost-cutting this spring, New York's Medicaid spending is on track to jump by 6 percent this year thanks to a massive influx of federal aid. Read More

New York Has Widened Its Lead in Per-Capita Spending on Medicaid

New York's per-capita Medicaid spending soared to more than double the nationwide rate in 2018, widening its gap with the other 49 states. Read More

New York’s Medicaid Enrollment Surges to an All-Time High

New York's Medicaid program is growing at its fastest rate in six years, with a quarter-million additional enrollees landing in the safety-net health plan during the first three months of the coronavirus pandemic.  Read More

New York’s Health Premiums Remain Among the Highest in the U.S.

The average cost of New Yorkers' health benefits increased by less than the national average in 2019 but remained among the highest in the U.S., according to recently published federal data. Read More

Subscribe

Sign up to receive updates about Empire Center research, news and events in your email.

CONTACT INFORMATION

Empire Center for Public Policy
30 South Pearl St.
Suite 1210
Albany, NY 12207

Phone: 518-434-3100
Fax: 518-434-3130
E-Mail: info@empirecenter.org

About

The Empire Center is an independent, non-partisan, non-profit think tank located in Albany, New York. Our mission is to make New York a better place to live and work by promoting public policy reforms grounded in free-market principles, personal responsibility, and the ideals of effective and accountable government.