Mandates coverage keeps people uninsured

Like most states, New Hampshire struggles with the issue of affordable health insurance coverage for its citizens. Roughly 150,000 people across the state lack health insurance. Of this number, a large group, approximately 75,000, are working-age individuals or their families who choose not to buy coverage or who work for employers who cannot afford to pay for their coverage.

In most cases, this is caused by the high cost of premiums for health insurance, but it is being made worse by new and excessive health insurance mandates proposed by the Democratic-run Legislature, which are driving the cost of insurance higher and pushing more people into the ranks of the uninsured.

Simply defined, a state health insurance “mandate” is a requirement that an insurance company or health plan cover certain types of provider services, benefits and patient populations. The goal of mandates is to provide individuals access to important services like mammograms, well-child care, breast reconstruction and even drug and alcohol abuse treatments.

However, in recent years, mandates have become a tool for legislatures to appease special interests and offer coverage for services like acupuncture, massage therapy and wigs. In fact, over the past four decades, the number of state mandates across the nation has jumped from 10 in 1965 to nearly 1,900 in 2007, an increase of almost 20,000 percent.

The Council for Affordable Health Insurance recently estimated that mandated benefits currently increase the cost of basic coverage 20 to 50 percent, depending on the state. In other words, adding mandates to basic coverage is like forcing average Americans to buy an imported luxury car with all the bells and whistles for everyday use, rather than a regular car that they can actually afford.

With 38 health-care mandates in New Hampshire, one would think that all the essential procedures and services are covered. However, in this legislative session alone, many health-care mandates have been proposed by the Democratic-run Legislature, including hormone treatments for transsexuals, gastric bypass surgery for diabetics, infertility treatments and midwifery services.

Some claim that these New Hampshire mandates will make health insurance more comprehensive and less expensive by increasing access to needed services. The reality is these mandates will actually reduce access by increasing the cost of basic coverage for New Hampshire citizens. In fact, an Urban Institute study shows that as much as one-fifth of the uninsured national population does not have coverage because of the cost of mandates.

As these mandates continue to rise, so does the cost of providing basic coverage for employers.

According to the New Hampshire Center for Public Policy Studies, the cost of health insurance is growing by 10 percent per year. As these costs become unaffordable, employers in an increasingly competitive marketplace either shift more of the costs to the employees, negatively impacting wages, or stop offering health insurance altogether.

Preserving access to quality affordable care for New Hampshire citizens continues to be one of my top priorities. Instituting more and more excessive mandates will only worsen the current uninsured problem in our state. As employers continue to drop coverage in the face of rising costs, more and more individuals and families will continue joining the ranks of the uninsured or be pushed into government-run programs like Medicaid.

It is time to stop using the ruse of mandates to disguise efforts to push our state and country toward single-payer, government-controlled health care. We need to give our citizens and their employees the opportunity and choice to buy affordable insurance that covers their families’ health needs. It is time to stop the practice of passing mandates for the sake of gaining political points.

U.S. Sen. Judd Gregg, R-N.H., is a member of the Senate Health, Education, Labor and Pensions Committee.