News & Information

LABOR & EMPLOYMENT LAW — 6/12/08

States now impose almost 2,000 health insurance mandates

States have implemented 1,961 health insurance mandates, defined as a requirement that an insurance company or health care plan cover (or offer coverage for) health care providers, benefits, and patient populations. While mandates make health care more comprehensive, they also make it more expensive.

Those figures come from a report issued by the Council for Affordable Health Insurance (CAHI), an advocacy group of insurance carriers in the individual, small group, health savings account, and senior markets. The report, "Health Insurance Mandates in the States 2008," estimates that mandated benefits currently increase the cost of basic health care coverage from 20 percent to 50 percent, depending on the state.

CAHI has been tracking state mandates since 1992. Of the variety and scope of health insurance mandates issued, the group has identified three current trends: eligibility mandates, coverage for autism, and coverage for the cervical cancer/human papillomavirus (HPV) vaccine.

Eligibility mandates. The past few years have seen an increase in mandates in which health insurance coverage is extended to unmarried dependents or students up to the age of 30. In 2007, CAHI also identified several new categories for health insurance coverage eligibility, such as "legal alien" and "elderly parent."

For example, Maine has extended eligibility for health insurance coverage to include a person who is not yet a US citizen but who is residing legally in the country. Oregon added a coverage provision for elderly parents who meet certain criteria.

In addition, at least four states--Maryland, Minnesota, New York, and Texas--have extended eligibility for health insurance coverage to include a grandchild who is financially dependent on the grandparent.

Autism. Autism, including treatment for its various complications, is currently one of the most widely discussed mandates, according to CAHI. In the past, autism had fallen under the broader category of mental health, but one of the latest state legislative trends is to pass an autism mandate separately from mental health benefit mandates. Presently, 11 states have an autism-specific mandate.

HPV vaccine. Over the past several years, CAHI found that 29 states have enacted an HPV screening mandate. In addition, 16 states have enacted a mandate to cover the HPV vaccine.

For more information on this and other topics, consult CCH Employment Practices Guide or CCH Labor Relations.

Visit our News Library to read more news stories.