FIRST thing you should know about health insurance mandates: They do nothing for the uninsured. Second thing you should know: They increase the number of the uninsured.
So in helping the insured get better coverage, mandates throw more people out of coverage. This is a true the-rich-get-richer, the-poor-get-poorer story.
Supporters of an autism mandate in Oklahoma are strategizing about how they'll cross the goal line next year. That line eluded them last year as Republican lawmakers refused to hear their pleas — even as Democratic lawmakers refused to consider a mandate cost/benefit law.
So much emotion surrounds mandates that it's easy to forget that they're increasing the number of uninsured citizens in a state recently identified as having the nation's worst uninsured rate. Why, then, would we even consider passing what would be Oklahoma's 37th mandate and a particularly expensive one at that? Why are we not considering bills to require that proposed mandates be subject to a cost/benefit analysis and allowing health care policies to be sold without mandates?
The Independent Insurance Agents of Oklahoma, which joins us in opposing mandates in principle, said 17 mandates were proposed in Oklahoma this year. None made it through and few were even noticed. But, as sports fans say, wait until next year!
Most mandates up the cost of policies by less than 1 percent. Some, such as mental heath services, increase premiums by 5 percent or more. The money goes to the providers who lobby for mandated coverage.
Isn't income protection the real motive behind insurance industry opposition to mandates? Hardly. Risk firms don't gain from mandates. They merely pass on increased costs. And insurance agents would actually make more money if mandates were increased — the higher the policy premium, the higher their commissions.
In at least 30 states, a proposed mandate's cost must be assessed before it's implemented. Not here. In at least 10 states, but not here, policies can be purchased under the "mandate-lite” plan, reducing premiums as well as benefits.
Mandates range from the sublimely sensible (mammograms) to the weirdly ridiculous (one state mandates coverage for athletic trainers). Ten states mandate coverage of hair prostheses (cancer wigs), while only two mandate coverage for smoking cessation.
Mandates happen because pressure groups make it difficult for lawmakers to resist. This is why the autism coverage debate this year degenerated into an irrational, subjective melee over a mandate for a controversial and expensive treatment modality.
Last thing you should know about mandates: They don't necessarily achieve the greater good of covering the most people for the most basic health care services.
Mandates are an exclusive boutique solution to a box store problem.
Mandates happen because pressure groups make it difficult for lawmakers to resist.
