State mandated health benefits have been undercounted; Now at 992, study finds.
ALEXANDRIA, Va. -- There are far more state mandated benefits in effect than previously reported, according to Health Benefits Letter, which announced its newly-released study.
According to Greg Scandlen, publisher of the letter, which focuses on health benefits reform on the state and federal levels, earlier reports show about 820 mandates in effect, while the new study identifies 992.
"Only a small part of the difference is due to new mandates passed this year," said Scandlen. "Most of the difference is the many mandates that have simply been overlooked in the past." Thirty-two new mandates have been enacted so far in 1991. Scandlen said the Health Benefits Letter has gone back over old reports and state statutes and discovered that other studies have missed many of the mandates that require payment to dentists, osteopaths, psychologists and other health care professions.
"Many of these laws were passed in the late 1960s and early 1970s, and have become so commonplace that nobody thinks of them as an issue anymore. I'm still not sure that we have caught every single mandate in the dusty corners of the statute books," he said, "but we're working on it."
Scandlen said that if it is this hard for us to simply count the mandates, "think about the problems employers must face in trying to comply with them." Scandlen said some of the laws exempt Blue Cross Blue Shield plans, a lot of them exempt HMOs, most exempt individual, non-group contracts, and a few only apply to groups with over 20, 50 or 100 employees. Some apply to contracts issued in another state, others don't.
"In some states the insurance commissioner is authorized to enact a mandate through regulation, in other places, the courts have effectively mandated coverages through case law. Keeping track of all this is a nearly impossible task," Scandlen said.
The newsletter points out that while insurance carriers have been "roundly criticized" for the "excessive administrative costs," the plethora of mandates varying by states, make it clear that the cost of compliance is inherently expensive.
The leading state in the number of mandates is Connecticut, with 37. followed by Maryland with 35 and by Minnesota and California, with 32 each. New York has 29 and New Jersey 20. The states with the fewest mandates, each having 9, are Alaska. Delaware. Idaho and South Carolina.
Copies of the study results, including the state-by-state table listing all 992 mandated benefits, may be ordered from the Health Benefits Letter at a cost of S5. Write to HBL, P.O. Box 19288. Alexandria, Va. 22320.