Gov. Malloy Proposes Limitations on Health Insurance Coverage Mandates

Annually, Connecticut state legislators discuss proposals to expand what health insurance plans must cover. For 2017, that is expected to include substance abuse treatment, breast pumps, insulin injectors and fertility preservation. However, expanded coverage tends to impact premiums, resulting in increases for certain plans and in response, Governor Dannel Malloy proposed a limitation on these mandates and changes to their review process.
According to H.B. No. 7042, the state’s General Assembly cannot create any health benefit mandate, unless it has first been reviewed for its cost impact, safety, current availability and effectiveness in treatment. Ultimately, if the bill is passed, any mandate will be evaluated for any costs or savings it adds to those insured.
Additionally, the bill would further restrict how many proposed benefit mandates could be reviewed each year. Should it pass, the Insurance and Real Estate Committee would select up to five and the UConn Center for Public Health and Health Policy, or an actuarial firm, would evaluate each one based on the points listed above. Currently, the state has a review program, but it’s only used when an insurance committee requests it. Coverage mandates also continue to be passed without prior review.
As the CT Mirror points out, the premium increases brought about by mandated coverage don’t affect everyone equally. Rather, large and small businesses purchasing group coverage seldom see increases and instead, those who purchase individual coverage bear the brunt.
Especially because the Affordable Care Act could be repealed, not everyone in the state Senate is on board with this proposal. To the press, Senate President Pro Tem Martin M. Looney, D-New Haven, explained that now is not the right time for this change. “We may need a lot of additional flexibility in terms of mandates and other things if the Affordable Care Act is repealed.”
If you’ve previously seen your policy increase or you’re unsure about what your plan covers, work with your agent at Ion Insurance to explore your options. To start, give us a call at 203.729.5261.