doctor-1461912176mgq-300x200-1649017With a line-item veto last week, Governor Andrew Cuomo put a last nail in the coffin of a good idea that was never given a chance by Albany: analyzing the costs and benefits of health insurance mandates before passing them into law.

Cuomo’s veto No. 109 eliminated a $300,000 reappropriation for the Health Care Quality and Cost Containment Commission, which was established in statute in 2007 but never had a single meeting.

The panel was supposed to study the impact of proposed coverage mandates on both the health and pocketbooks of New Yorkers. But that important mission went unfulfilled because governors and legislative leaders never completely filled its 13 seats.

Now, even if the state’s leaders finally followed through on their own law, the panel would lack the funds necessary to do its job.

It was one of 75 budget items preserved by the Legislature that Cuomo vetoed on grounds that the money had gone unspent for seven years or more.

Most will not be missed: Also getting the ax was unused funding for a commission to mark the 250th anniversary of the French and Indian War – an anniversary that ended in 2013.

The need for a reality check on insurance mandates, by contrast, remains as great as ever – with no fewer than 92 proposals pending in this legislative session alone. Some would require health plans to pay for costly procedures, such as in vitro fertilization for women who are unable to get pregnant. None offers an actuarial estimate of how premiums would increase as a result.

The bills often demand coverage for techniques that have yet to be proven effective in clinical studies, or for screening that goes beyond the consensus recommendations of experts.

They cover only a fraction of insurance consumers – because state regulations apply to individual and small-group policies, but not to the benefits of large employers that self-insure. Meanwhile, the bills usually drive up the cost of the policies they do affect, making coverage harder to afford and adding to the ranks of the uninsured.

A 2003 study commissioned by the business-aligned Employer Alliance for Affordable Health Care estimated that mandates in force at the time in New York added 12.2 percent to the cost of insurance, or more than $1,000 a year for family coverage. That figure has likely increased as the Legislature added new coverage requirements in the years since.

The state’s ever-growing list of mandates, along with its heavy taxes on health insurance, help to explain why New York has the highest premiums in lower 48 states.

Last month, the Empire Center launched a Mandate Watch to track the dozens of mandate bills currently pending before the Legislature, each of which has the potential to push insurance costs even higher, and none of which is likely to receive expert cost-benefit analysis.

To their credit, Erie County Senator Patrick Gallivan and Monroe County Assemblyman Peter Lawrence, both Republicans, have introduced legislation that would call for the commission’s seats to be filled within 90 days and beef up its powers.

Even if such a law were to pass, however, who’s to say the state’s leaders wouldn’t ignore that one, too?

 

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

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