Health Insurance Mandates: The Most Expensive Laws You’ve Never Heard Of

Quick: name three things that make your life a lot more expensive.

Bet you went with “taxes, taxes, taxes,” or maybe “kids, kids, kids.” But did the word mandate sneak into that list anywhere?

Probably not. If you’re like most North Carolinians, you didn’t know that health insurance mandates are the number one reason our healthcare prices are rising so rapidly (almost 30% in the past year alone. Shocking, right?).

In fact, you may not even know what mandates are, much less how they’re crippling our economy.

That’s okay. We’re here to break it down for you.

What Are Mandates?

Mandates are laws that require health insurance companies to pay for something. They enforce coverage for certain providers, benefits, or patient populations. You may have heard of mandates in the context of the ACA (or Affordable Care Act), which instituted mandates at the national level to cover services like mammograms and mental health screenings. But mandates passed by individual states on an ongoing basis are even more common. And the more mandates we pass, the more expensive healthcare becomes for all of us.

Why? Simple economics. To cover the cost of each mandate, health insurance providers raise everyone’s prices. That’s why the average family premium in 2014 was almost $5,000 — and why it’s continuing to climb.

Mandates and Special Interest Groups

But many mandates benefit just a sliver of North Carolina’s population. They are pushed through the legislature by special interest groups that do not have the entire state’s wellbeing in mind.

For instance, North Carolina has a mandate on the books that requires health insurance companies to cover chiropractors at the same rate they cover general practitioners, even though GPs have gone to medical school and can provide lifesaving healthcare services.

Aside from this mandate’s questionable history, there’s another significant problem: it only benefits a few of us. In 2015, the Gallup-Palmer College of Chiropractic said that only 14% of Americans had used chiropractic services in the past year. North Carolina’s chiropractic mandate requires us to sacrifice the fiscal health of the many to serve the few.

Mandates and Taxes: Not Much Difference

As the Gershwin brothers penned, “You like to-may-toes and I like to-mah-toes.” We say that’s mandates and taxes. A tax is a fee you’re required by law to pay. So is a mandate.

So think of a mandate as a form of a tax — one you didn’t know you were paying. Then remember the fiscally conservative platform the current legislature ran on. Finally, ask this: Is it inconsistent for legislators who fought for tax reform to vote for mandates in record numbers? Because we think it is.

North Carolina has more than 50 mandates, and there’s no end in sight...unless someone does something about it. We intend to.

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