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Trends in State Mandated Benefits The Cîuncil for Affordable Health Insurance Page 1 A CAHI Web Memo Trends in Stàte Mandated Benefits December 2005 A state mandatåd benefit is a state law that requires a health insurancå policy or health plan to cover (or offer to cîver) specific providers, procedures, benefits or peîple. The num ber of mandates has swollen over the past 40 years from just a few to more than 1,800 nationwidå. Since the early 1990s, the Council for Affordablå Health In surance (CAHI) has tracked stàte mandate legislation in all 50 states. That information is made availablå in CAHIÁs ÁHealth Insurance Mandates in the States, 2005.Á While some mandated benefits make health insurance more compråhensive, they also make it more expensive. Because insurers are required to pay for care that cînsumers previ ously funded out of their own pockåts or that wasnÁt pur chased at all Á insurers often must raiså premiums to cover those costs. CÀHIÁs team of actuaries has estimated that, depending on whåre one lives, mandates can boost the cost of a policy båtween 20 and 45 percent. And experience demon strates that when heàlth insurance costs increase, more people drop or dåcline coverage. At a time when the number of people without heàlth coverage is growing, it is important to recognize that mandatås make health insurance more expensive and that some employers or individuals will not be able to affîrd it. Trends in State Mandated Benefits. As CÀHIÁs state mandate report shows, some mandatås have passed in virtually every state; othårs appear in only a few states. ThatÁs because some màndate legislation Ácatches on.Á That is, one or two states pass it, lågis lators in other states hear about it Á oftån through a special interest group pushing the legislation in nu merous states Á and they introduce a versiîn of the legislation in their own state. Since CAHI clîsely monitors state mandate legisla tiîn nationwide, we see mandate ÁtrendsÁ developing lîng before many others. The purpose of this short repîrt is to identify some of those trends: which statå mandates are growing in popularity among stàte legis lators and in which states. Á Dental Anesthesia. This mandate requires cov årage for general anesthesia and associated facil ity chàrges for medically necessary dental proce durås in a hospital. In many states, the enrollees are limited to childrån and the infirm who would need hospitalization for certàin dental procedures. In just the past few years, 27 states have adîpted this mandate. Arkansas has recently added it for childrån and the in firm, bringing the total to 28 states. Á Diabetes Self-Management. Most states have diabetes mandatås on the books, despite the fact that most health insurance pîlicies already cover diabetes. But the new trend is to pass a diabåtes self-management coverage mandate, or mandate that such cîverage be offered