The Council for Affordable Health Insurance has released a report arguing that health insurance mandates make insurance more expensive because they unnecessarily require “insurers to pay for care consumers previously funded out of their own pocket”:
Mandating benefits is like saying to someone in the market for a new car, if you can’t afford a Cadillac loaded with options, you have to walk. Having a Cadillac would be nice, as would having a health insurance policy that covers everything one might want.
Comparing health insurance mandates to luxury cars is both disingenuous and misleading. While the Council concedes that “just because we list something as a mandate doesn’t necessarily mean it should be excluded for a standard health insurance policy,” its list of 65 benefits contains at least 16 services that prudent individuals would expect insurance policies to cover — these benefits are the wheels in the Center’s car analogy.
Indeed, states have had to require companies to cover the most basic of services: cancer medications, cervical cancer/HPV screening, ovarian cancer screening and prostate cancer screening:
- 44 states: mandate emergency services
- 50 states: mandate mammograms
- 29 states: mandate cervical cancer/HPV screening
- 28 states: mandate colorectal cancer screening
- 31 states: mandate well-child care
As the Center for American Progress’s Peter Harbage explains:
In large part, the reasons the mandates exist is because insurance companies don’t want to know if their enrollees have cancer in the hopes that person will change jobs (and insurers) before surgery is needed…And then, here is the funniest thing about the mandates, most people when they get a policy don’t look to see about well-child visits or cancer screening or anything else because, like most things in life, you don’t look for it until you need it. More than that, most people are crazy enough to think that a maternity stay in a hospital is of course part of their insurance plan. The mandate laws passed for a reason.
Moreover, the council suggests that if insurance companies could market their policies across state lines they could offer cheaper policies “by allowing individuals to get around their state’s coverage mandates and pick a less-comprehensive plan.” But lifting mandates would place the most basic services out of the reach of most Americans.
Without mandates, insurance companies would have no incentive to offer coverage for chronic conditions or expansive procedures, leaving the sickest Americans without any health insurance. In fact, insurers that continue to extend coverage for certain procedures would quickly find themselves at a competitive disadvantage with insurers that provide the least coverage.
Thus, the Council’s message is simple: health insurance should only be available to the healthiest Americans.