AFFORDABLE HEALTHCARE SCORECARD ALERT – Cost-Increasing Mandate

May 13, 2021

A North Carolina General Assembly proposal (House Bill 703) would mandate that millions of dollars be added to the healthcare system and encourage misuse and overuse. 

The Coalition is OPPOSED.

Specifically, the bill mandates that individuals and businesses, through their insurance premiums, pay for advanced diagnostic imaging tests such as MRIs and breast ultrasounds at the same level as a preventive screening mammography.  

Screening mammograms are considered a preventative service with no cost share under the ACA, whereas diagnostic tests are not considered preventive. The US Preventive Services Task Force recommends conventional mammography for screening. 

Mandating zero cost share for diagnostic tests would cause more than $7 million in estimated premium escalation. It could also encourage overuse and misuse as tests such as MRIs and diagnostic breast ultrasounds more expensive for patients – and more profitable for providers. 

Actions related to this bill will be factored into a member’s Affordable Healthcare Grade at the close of the legislative session.


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