Mandating that Health Plans Cover Certain Services Keeps Insurance Out of Reach for Many, Op-Ed Says

While legislatively mandated health insurance benefits are "well-intentioned," they make it "harder" for Maryland residents to purchase health insurance, columnist Jay Hancock writes in a Baltimore Sun op-ed. The Maryland General Assembly last year mandated health plans cover colon cancer tests, children's hearing aids and weight-loss medications and this year is considering mandating coverage of meningitis vaccines and mental health crisis care at home, as well as expanding coverage of contraceptives and in vitro fertilization. In total, Maryland mandates insurers cover 40 benefit areas. "Many mandates are luxuries in a state with 800,000 uninsured people," Hancock says. He notes that those mandates account for $814, or 14%, of the cost of an average non-HMO group plan, according to a study by William H. Mercer Inc. According to Hancock, if the mandated benefits were eliminated, the cost of insurance would decrease and "at least" 12,000 -- "and probably a lot more" -- of the 800,000 uninsured Maryland residents could afford coverage. Hancock adds that higher premiums resulting from mandates force many companies to stop offering employees health coverage altogether. In fact, the "most perverse" part of mandated benefits is that they "drive up the cost" of insurance "precisely for the companies that can least afford it" -- small and medium-sized companies, Hancock writes. Larger employers generally are self-insured and thus exempt from state mandates because they are regulated federally. Hancock suggests that if workers "demand" certain types of coverage, then employers will offer them "without being forced." If not, then "maybe patients should pay" for certain services, Hancock writes. He concludes, "Let's worry first about covering everybody for appendicitis and broken legs. We can worry about in-vitro fertilization later" (Hancock, Baltimore Sun, 3/20).