La. Debates Commission on Health Benefits Mandates

Published August 1, 2009

Louisiana state Rep. Thomas McVea (R-St. Francisville) has introduced legislation to create a commission that would study proposals for new health insurance mandates before they receive legislative consideration.

The organization created by House Bill 438, the Louisiana Mandated Health Benefits Commission, would review all proposed legislation to mandate coverage of benefits, services, conditions, or medical products and report its findings to the legislature annually.

Screening Impact

The commission would be required to evaluate the likely medical impact of proposed mandates, including whether the proposed service or product would be “generally recognized in the medical community as effective in screening, diagnosis, or treatment of a condition, as demonstrated by a review of scientific and peer-reviewed medical literature and whether the service or product is currently used by health care providers,” according to the bill’s text.

The commission also would evaluate the social impact of proposed health insurance mandates, including the level of public demand for the proposed service or product, the extent to which it is already provided, and the short-term and long-term good expected from it.

Finally, the commission would be responsible for evaluating the financial impact of propose mandates, including the projected cost of providing the service or product, the projected impact on health insurance premiums, the effect on the number of uninsured residents in the state, the projected increase in utilization of the service or product, and the projected cost savings by providing that coverage.

Addressing a ‘Serious Problem’

“I think [HB 438] is attempting to address a serious problem: that of insurance mandates,” said Kevin Kane, president of the Louisiana-based Pelican Institute for Public Policy. “Mandates drive up the cost of health care and limit the ability of insurance companies to offer a wider array of options to their customers.

“Politicians are reluctant to vote against mandates, as the advocates for required coverage are usually quite sympathetic,” Kane continued, “so I can understand why many would prefer a more independent board to weigh the costs and benefits of such mandates.”

Seats at the Table

The commission would consist of 15 members, who would serve without pay.

Voting members would include representatives from the American Association of Retired Persons, Louisiana AFL-CIO, Louisiana Coalition for Maternal and Infant Health, Louisiana Association of Business and Industry, Louisiana Association of Health Plans, Louisiana Association of Health Underwriters, Louisiana Business Group on Health, Louisiana Hospital Association, Louisiana State Medical Society, National Federation of Independent Business, and Office of Group Benefits.

Ex-officio members, who would not have a vote in the commission’s decisions, would include a member of the Senate Committee on Insurance and one from the House Committee on Insurance, each of whom would be appointed by the chairman of the respective committees. Other nonvoting members would include a representative of the Legislative Fiscal Office and an actuary appointed by the state’s commissioner of insurance.

Market Typically Shortchanged

“It is safe to say that all states need more market-based policy solutions,” Kane said. “Unfortunately, the federal government has taken such a large role in health care that states do not seem very eager to innovate. Instead they have come to rely on generous federal spending and do not do enough to curb spending at the state level.”

The legislation is currently being considered by the Louisiana State House Committee on Health Insurance.

Sarah McIntosh ([email protected]) teaches constitutional law and American politics at Wichita State University in Kansas.

For more information …

Louisiana House Bill 438: