What do acupuncturists, drug abuse treatment, and non-custodial children have in common? Oregonians cannot buy private health insurance that does not pay for or cover all three. They represent three of the state’s 33 health insurance mandates. Mandates are benefits, providers, and persons that must be included in all private health insurance policies. The list of mandates is expanding: The legislature added contraceptives, prosthetics and orthotics, and treatment for intoxicant-related injuries in the recently-concluded 2007 session (House Bills 2700, 2517, and 2348 respectively).
Requiring insurers to cover more conditions seems like an attractive way to ensure a healthier population; and for people with health insurance, it might be. But mandates have a downside. Covering more conditions costs more money; and for private insurance, that money comes from higher premiums. Last year, nearly 700,000 Oregonians said they lacked health insurance for at least part of the previous 12 months. Three quarters of them said cost was a factor. For 296,000 Oregonians, cost was the only factor keeping them from getting health insurance (Oregon Population Survey). If legislators want to get serious about insuring more Oregonians, they should take steps to decrease, not increase, the cost of insurance. Halting or reversing the growth of mandates would be a key first step in that process.
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