Mandates Increase Insurance Costs

On Thursday, the House and Senate Commerce Committees will hold a rare joint meeting to discuss one of the bigger issues facing Iowans today – health insurance premiums. It was learned last week that 80,000 Iowans were receiving double-digit premium hikes for their state regulated insurance plans. Legislators will have the chance to ask Wellmark why this is happening and what can be done to lower the cost of health insurance for Iowans.

With the discussion over rising insurance premiums, Iowans expect their legislators to save them money. Iowans might be surprised that the majority party is, in fact, looking for ways to increase the demands on health insurers. All that means is one thing – even higher premiums in the future.

Currently, there are five different bills in the Legislature that would implement new requirements on health insurance plans. They are :

    House File 234 – Mental Health Parity
    The bill would require Iowa-regulated health insurance plans to offer the same level of coverage for mental health and substance abuse as the plan does for physical health issues. What is covered is based on the Diagnostic and Statistical Manual of Mental Disorders, which is used as the guidebook for psychiatric diagnoses. This book is being revised to add new recognized conditions. If House File 234 is adopted, this could require insurance plans to cover apathy disorder, internet addition, and gambling addiction.

    House File 2329 – Mandated Coverage of Medication Therapy Management
    The bill would require state-regulated insurance plans to pay pharmacists for counseling customers on the proper use of the prescriptions they receive and to also pay pharmacists for overseeing the different prescriptions of a customer.

    House File 2404 – Mandated Coverage of Audiology Services
    The bill would require Iowa-regulated plans to cover audiology exams, hearing aids and ear molds for children under the age of 18. Currently, the state has a program that provides hearing services to children without audiology coverage through the Dept. of Public Health for around $230,000 per year. The imposition of a mandate could increase the premium payments for state employee insurance plans by $600,000.

    House File 2410 – Substitution of Anti-Epileptic Drugs
    The bill would require a pharmacist to provide notice to a patient and their health care provider of the intent to substitute a different drug for what the provider prescribed when that drug is used for the treatment of epileptic seizures. Under Iowa law, a pharmacist has the authority to substitute an equivalent drug when it is cheaper for the patient. This bill would place another bureaucratic process on the pharmacist for this one type of drugs. It has the potential to raise the cost of health insurance by requiring the use of more expensive medications.

    Senate File 2349 – Mandated Coverage of Autism Services
    The bill would require public employee health plans to provide coverage for services to person with autism. This would the be first step towards a full mandate on all insurance plans regulated by the state.

While each of these bills address legitimate health concerns, the fact remains that requiring health plans to add this coverage means additional costs. And additional costs to insurance companies turn into higher insurance premiums for Iowans.

What Iowans need for the Legislature to focus on are ideas that can really lower costs. House Republicans have offered a number of ideas, including allowing insurance companies to sell mandate-free policies, offer basic health plans for young adults, and breaks for Iowans who undertake wellness efforts to reduce their need for health care services. Will Democrats join in fighting growing health care costs, or will they continue to pile on Iowans’ insurance bills?

  • Janet Clark

    House File 2410 is a good, reasonable bill. It’s a simple solution to a horrific problem. People with epilepsy struggle to have a normal life: why are you putting another obstacle in their paths?