Newspaper article THE JOURNAL RECORD

Commentary: Office Visit: Mandates: One Size Doesn't Fit All

Newspaper article THE JOURNAL RECORD

Commentary: Office Visit: Mandates: One Size Doesn't Fit All

Article excerpt

With the start of this year's legislative session drawing near, health care is sure to be a topic high on many Oklahoma lawmakers' lists. If you're like me - an average "Joe" - it's important to stay informed about proposed initiatives that may affect your business and employees.

One legislative issue that impacts health care is mandated benefits. A mandated benefit is a law that requires a health plan to cover - or offer to cover - specific providers, procedures, benefits or people. Oklahoma currently has 36 health insurance mandates.

While mandated benefits make health insurance more comprehensive, they also can make it more expensive and less accessible to consumers. In some cases, mandates require insurers to pay for care that consumers previously funded out-of-pocket, if they purchased it at all, so insurers have higher benefit costs - and eventually they must raise premiums to cover those costs.

The unfortunate irony is that the costs of state mandates impact fully insured businesses, which are usually smaller employers that can least afford higher premium costs. Many large employers have self-funded plans that are regulated by federal law - specifically the Employee Retirement Income Security Act, or ERISA. These ERISA- governed plans are generally exempt from state-law-mandated benefits.

It's not a question of whether the health care addressed in the mandates is a good idea. In a perfect world, every business owner would gladly provide additional coverage on every insurance policy they offered. The reality is small business owners have to watch how much they spend on an employee's health insurance - too much and they may reduce benefits or drop health coverage altogether. …

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