CAHI Identifies 2,262 State Health Insurance Mandates


ALEXANDRIA, Va., Feb. 28, 2012 /PRNewswire-USNewswire/ -- Today the Council for Affordable Health Insurance (CAHI) released "Health Insurance Mandates in the States, 2011." According to the study, the number of state mandated benefits increased by over 100 mandates to 2,262 nationwide last year, up from 2,156 in 2010.

"One of the biggest cost drivers in our health care system is the steady proliferation of federal and state-based coverage mandates.  When CAHI started tracking mandates in 1992, there were about 850 mandates across all 50 states," explained CAHI Research and Policy Director, Victoria Craig Bunce. "According to CAHI's research, over the last twenty years the number of state mandated benefits has grown to 2,262. That's an increase of 166 percent! Based on our annual analysis, mandated benefits currently increase the cost of basic health coverage from slightly less than 10 percent to more than 50 percent, depending on the state, specific legislative language, and type of health insurance policy." 

Most Mandated Benefits



Least Mandated Benefits




Most Popular Mandates



Least Popular Mandates

Rhode Island






Mammography Screening



Breast Implant Removal








Maternity Minimum Stay



Cardiovascular Disease Screening








Breast Reconstruction











Mental Health Parity



Gastric Electrical Stimulation








Alcohol & Substance Abuse



Organ Transplant Donor Coverage


"The sheer number of state mandates will make it difficult for states to deliver on one of the key promises repeatedly made by supporters of the new federal health care reform law: that it would provide all Americans with affordable health coverage.  The recent guidance from the U.S. Department of Health and Human Services on the design of the essential health benefit plans ostensibly grants states the flexibility to craft affordable benefit packages suitable to their populations.  But those states that adopt their current small employer health insurance plan for this purpose will, as our report illustrates, shackle consumers with coverage that is already overloaded with dozens of existing state mandated benefits. These mandates, layered on top of the new federal coverage mandates, will inevitably drive up costs for everyone.  This will actually worsen, rather than fix, the issue of health insurance that is priced out of the reach of many individuals and small employers," explained Roy Ramthun, CAHI's Director of Federal Affairs. 

A health insurance mandate requires insurers to cover specific health care providers, benefits or patient populations. Mandates make health insurance more expensive because they require insurers to pay for care consumers previously funded out of their own pockets.

When policymakers complain about the high cost of health insurance, CAHI wants legislators to know they are partially to blame.  The mandate explosion and the corresponding effect on the cost and availability of health insurance is a direct result of legislative action. We hope this publication will encourage them to think twice when asked to sponsor or vote on legislation which contains a mandate providing services to the few at the expense of the majority.

The study's author, CAHI Research and Policy Director Victoria C. Bunce, assisted by CAHI staff, tracks hundreds of mandate bills annually and identifies those which are enacted into law.  A team of actuaries, supervised by CAHI's Actuarial Working Group on Mandated Benefits provides an estimate of each mandate's cost. A copy of the study is available by emailing [email protected].  For an executive summary, please visit

Since 1992, CAHI has been the principled, free-market voice protecting and promoting access, affordability and choice in American health care.  CAHI's membership includes health insurers, small businesses, physicians, actuaries, insurance producers and brokers and consumers.  It's your health; it's your choice.






SOURCE Council for Affordable Health Insurance