The Center for Modern Health just released a report “Paring Down Coverage Mandates To Reduce Health Insurance Premiums“. It builds on one of my papers to estimate how much states could drive down insurance premiums by reducing the number of things health insurers are required to cover:
It’s nice to see that someone in the health policy world remembers that health insurance benefit mandates exist and can be a significant cost driver. I’m also glad to see that someone still cares about my 2014 paper (the first one I ever got accepted at a journal), though I wish there were more up to date estimates available for them to cite.
Why has no one developed more recent estimates? Partly for data reasons- the organizations that had been putting out counts of mandates by state each year (the Council for Affordable Health Insurance & Blue Cross Blue Shield Association) stopped doing so. Partly because of the ACA, which changed how mandates worked in complex ways.
That said, there there seems to be some more recent data from 2017 that could be used for a slight update, and this post and my ideas page detail the many things we still don’t know about how mandates operated prior to 2014:
State Health Insurance Mandates: Most of my early work was on these laws, but many questions remain unanswered. States have passed over a hundred different types of mandated benefits, but the vast majority have zero papers focused on them. Many likely effects of the laws have also never been studied for any mandate or combination of mandates. Do they actually reduce uncompensated hospital care, as Summers (1989) predicts? Do mandates cause higher deductibles and copays, less coverage of non-mandated care, or narrower networks? How do mandates affect the income and employment of relevant providers? Can mandates be used as an instrument to determine the effectiveness of a treatment? How does all this change in light of the ACA? On the identification side, redoing older papers using a dataset like MEPS-IC where self-insured firms can be used as a control would be a major advance.
