State Health Benefit Mandates Come with New Costs

Margaret Dick Tocknell, for HealthLeaders Media , March 14, 2012

The NIH study looks at Maryland and its 67 mandates to develop an example of what a state mandate liability might be. One analysis shows that Maryland's liability for mandates in 2016 would range from $10 million to $80 million depending on the benchmark plan selected. That  may sound like a lot of money, but it's a drop in the bucket for most state budgets.

Looking ahead to 2014 when health insurance coverage will begin through state exchanges, the study suggests that the exchanges will provide states with new and more effective ways to regulate benefits in the individual and small group markets.

"Since states will be selecting a benchmark plan to regulate the benefits covered, the regulatory focus can shift from service-specific benefit mandates to a broader focus on the overall scope of benefits that are covered."

The study further notes that states may use their authority to certify qualified health plans as a way to exclude plans that offer inadequate benefits. "This authority can be used in addition to—or instead of—benefit mandates."

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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