Monday, September 21, 2009

Insurance mandates: Would relaxing the number of required health-insurance benefits make coverage dramatically cheaper?

Probably not, according to Washington state's top insurance official. A Q&A published this weekend by The (Vancouver) Columbian includes this exchange:

Some Republican legislators argue that the mandates the state imposes on insurance companies drive many companies away. Does Washington impose an unusually high number of mandates compared with other states?
Kreidler: That depends on how you define mandates. If you look at the ones that cover specific benefits such as cancer screenings, I think our number is fairly consistent with what you see in most states.
We don't allow insurance companies to effectively determine your premium by your health status. Medical underwriting is prohibited for insurers in the small-group market and the individual market. My guess is, the insurance companies consider that a mandate.
If Washington eliminated all the mandates, how much would it save?
Kreidler: The best estimates are about 3 percent.

Washington state mandates 14 health benefits (like diabetes coverage, colorectal cancer exams, mental health parity and mammograms), 10 mandates related to access for specific types of providers (chiropractic care, podiatrists, psychological services) and several coverage requirements (like coverage for dependent children). Insurers must also offer -- although employers don't have to buy -- coverage for things like hospice care and temporomandibular joint disorder.

There are also 11 federal mandates, some of which overlap with Washington's state requirements.

Click here for a detailed description of these mandates and what they mean.

Kreidler on health-insurance reform: "We cannot afford to fail again"

Washington state Insurance Commissioner Mike Kreidler, in an op-ed piece in today's Seattle Times, writes:

Every day, desperate people seek help from my office.

One woman lost her job and health coverage, only to discover her husband needed a critical operation. Another couple, both 62, struggle to pay $1,400 a month. And a retired couple is trying to help their uninsured son — a heart-transplant recipient — pay $2,000 a month for medication.
Good, affordable health insurance eludes more and more of us. Many people are only one accident or serious illness away from bankruptcy. And even many of those with good coverage know it may not be there tomorrow. Across the country, this anxiety hangs over workers' and families' heads.
I had a front-row seat during the last major attempt at reform. Sixteen years ago, I was a congressman on a key House health subcommittee. We failed then. We cannot afford to fail again.