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Thursday, October 7, 2010

Cost of Insurance Mandates

The Las Vegas Journal-Review reports:

A big Nevada insurer who didn't want to discuss the political hot potato on the record has crunched the numbers and found the mandate will add 2.2 percent, or about $100 a year, to Nevadans' annual premiums.

That's a "very significant impact," given that most new mandates add less than 1 percent to premium costs, said J.P. Wieske, executive director of the Council for Affordable Health Insurance in Alexandria, Va.


Wieske's council published a 2009 study that also set Nevada's autism premium impact at roughly 1 percent, but Wieske said the group is updating its numbers, because the council's initial assumptions didn't account for "explosions" in the number of autism diagnoses and the condition's care costs. He said he now believes the Nevada insurer's projection of a 2.2 percent premium impact is likely to be at least fairly close to the actual effect. The state's actuarial study also acknowledged that the future costs of some therapies were "uncertain" due to increased insurance coverage.


Susan Pisano, a spokeswoman for Washington, D.C.- based trade group America's Health Insurance Plans, said her association isn't concerned about the autism mandate itself. Rather, the organization's issue is with policy requirements in general, which she said typically become law without regard to their effects on health-care quality or costs. Nor do mandates always come from scientific evidence that certain treatments will help, she said.


Autism mandates in particular have grown popular among states in the past two to three years. Nearly half the states, 23, require insurers to cover it. Some of the surge comes from high-profile advocacy efforts in front of state legislatures, Wieske said, while part of the push involves sympathy for a condition that largely affects small kids. Plus, it's only been in recent years that doctors began to better understand autism and its treatments, he said.

But at least part of the jump in autism mandates originated with subtle attempts to shift the cost of care for the condition away from school budgets and into private insurance, Pisano said. Wieske agreed, noting that interventions such as speech therapy were typically covered through school districts and states, until widespread budget crunches pinched what the public sector could or would provide.