Mandate Update, since the early 1990’s; the Council for Affordable Health Insurance (CAHI) has tracked state health insurance mandate legislation in all 50 states.
A health insurance “mandate” is a requirement that an insurance company or health plan cover (or offer coverage for) common- but sometimes not so common- health care providers, benefits and patient populations. They include:
Providers such as chiropractors and podiatrists, but also social workers and massage therapists;
Benefits such as mammograms, well-child care and even drug and alcohol abuse treatment, but also acupuncture and hair prostheses (wigs); and,
Populations, such as adopted and non-custodial children.
For almost every health care product or service, there is someone who wants insurance to cover it so that those who sell the products and services get more business and those who use the products and services don’t have to pay out of pocket for them, this is especially onerous if the people had previously not used the product or service anyway.
The Impact of Mandates. While mandates make health insurance more comprehensive, they also make it more expensive because mandates require insurers to pay for care consumers previously funded out of their own pockets. We estimate that mandated benefits currently increase the cost of basic health coverage from as little as 20% to more than 50%, depending on the state and its mandates.
Mandating benefits is like saying to someone in the market for a new care, if you can’t afford a Cadillac loaded with options, you have to walk. Having a Cadillac would be nice, as would have a health insurance policy that covers everything one might want. But drivers with less money can find many affordable car options; whereas when the price of health insurance soars, few other options exist. And when the people cannot afford the coverage, they join the ranks of the uninsured.
Although most mandates will have a relatively small impact when taken individually, it’s the cumulative effect that drives up the cost of coverage. Mandates also limit choices. Why should an older couple nearing retirement pay for maternity coverage, or a teetotaler pay for drug and alcohol abuse counseling?
One of the things you notice when tracking mandates is that often some legislative action catches on. For example, over the past several years we have seen a steady increase in the cervical cancer/human papillomavirus (HPV) vaccine mandate. Last year, 41 states introduced legislation to mandate coverage for this vaccine, and 24 states introduced legislation to mandate the HPV vaccine as part of the school entrance list. Kansas does not currently mandate this vaccine.
Kansas does have 37 listed mandates some of which are alcoholism and drug abuse treatment, breast reconstruction, mastectomy, maternity, mental health, new-born sickle-cell testing, chiropractors, dentists, nurse anesthetists, psychologists and social workers.
Source: CAHI, 127 S. Peyton Street, Suite 210, Alexandria, VA. 22314, www.cahi.org.
Last week, the City of El Dorado held an open house at the new wastewater treatment facility just south of town. This multi-million dollar facility can treat 2 million gallons of wastewater (sewage) daily and has an extended capacity for 6 million gallons during high rain levels events (toad strangler’s). The city has over 50 miles of sanitary sewer mains with 11 electric lift stations.
Using a bio-technological mix of equipment and processes the citizens of El Dorado have a state-of-the-art eco-friendly sewage treatment plant. This plant is the first in the State of Kansas and will allow for a more efficient and less expensive manner to treat our wastewater prior to it being returned to the river. Currently we are well below the EPA limits for treated water.
We have man-made wetlands that uses Mother Nature and her natural processes to aide us in removing toxins, ammonia and other chemicals from our wastewater. The wildlife abounds in the area and with a manmade pond that will be made available for fishing; the facility is a real jewel. Contact Kurt Bookout the Public Utilities Director for more information.
I will be returning to Topeka on the 28th of April for our final week of the legislative session. I hope to be home that following weekend, but with unfinished business we certainly will have long days to complete our work within the legal session limit time of 90 days. My office is part of the Capitol remodel, so I have to move out and will only have the use of my floor desk until next session begins in 2009.
I consider it an honor and privilege to represent you in Topeka and look forward to hearing from you.
After session contact me at home 1115 Rim Rock Road, El Dorado 67042, grange@house.state.ks.us, or johng@carlisleinc.net, or www.johngrange.net.
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