Health Care Mandates, Taxes and Regulations
Issue
How can we reduce the impact of health care mandates, taxes and regulations to reduce health care costs?
Policy
Policy changes must be made to reduce the impact of health care mandates, taxes and regulations on the cost of health care. Lawmakers continue to propose legislation that will expand government health care mandates that fall disproportionately on the fully insured market, increasing costs for mainly small and medium businesses. In addition, legislation has been proposed that would mandate employers to offer health insurance instead of it being a benefit used to compete for and retain good employees. Legislators should focus on reforms that will help make health care more affordable, not increasing mandates and regulations that will drive costs up.
- Minnesota imposes more mandates and regulation on health care coverage and services than almost any other state. Existing insurance mandates that do not provide measurable quality improvement and where benefits do not outweigh costs should be repealed. Where applicable, effectiveness should be measured based on evidence-based guidelines. The mandate review statute should be strengthened to ensure all mandates considered by the Legislature receive a balanced review of the cost, benefits and medical evidence prior to their enactment.
- The state should abide by Minnesota Statutes 43A.23, which requires the state to follow all mandates passed by the Legislature. In addition, the state, schools, cities, counties and other political subdivisions should be contributing members of the Minnesota Comprehensive Health Association program. The state also should fully fund any mandates it imposes on the health care system.
- Health care is a benefit employers offer to attract and retain good employees, not a requirement. The state should not impose a “pay or play” mandate on employers where they would be required to provide health insurance to their employees or pay the state a fee.
- The state should not require disclosure of the name of employers with employees on public health care programs.
- Minnesota imposes several health care taxes that add up to more than 6 percent of the cost of premiums for some employers and individuals. The taxes fall disproportionately on the fully insured market causing increased cost for mainly small and medium size employers and individuals. The state should reduce the additional costs it puts on the system in an effort to make health care more affordable for Minnesotans.
- Regulations that add costs and unnecessary delay to the existing health care system should be eliminated or streamlined. State policies should not make Minnesota distinctive relative to other states, thus making it difficult and more costly for insurance companies to participate in the Minnesota market.
- Expand product flexibility by allowing more options in co-payments, deductibles, cost-sharing and rating. Eliminate legal and regulatory barriers that make it difficult for plan design to act in response to market demand.
- Support efforts to provide a more open and competitive application process, including a singe uniform enrollment form for the small group market.
- Encourage value-based pharmaceutical care and medication therapy management that provides the best care at the lowest overall health care cost.
- Support federal efforts to balance the relationship between incentives that bring new prescription drugs to market and promoting competition and affordable drug coverage. Oppose efforts by the state to facilitate the illegal importation and purchase of prescription drugs from Canada or any other nation.
- Oppose government-mandated price control proposals.
- Support efforts to reduce the cost of medical liability on the health care system.
- Minimize/eliminate government cost-shifting to the private market.
- Oppose efforts to extend current medical liability to employers or further expand medical liability on health plans.
Business Impact
State-imposed costs add to the already high cost of health care and make it more difficult for employers to provide affordable coverage for their employees. State-imposed costs and regulations also fall unevenly on the market, usually affecting small- and medium-sized businesses and individuals disproportionately. These are often the companies and individuals least able to afford additional cost increases. At present, only one-third of Minnesota’s population is in a private insurance product regulated by the state. Employers who purchase in the state-regulated market often pay more for these benefits than self-insured employers. This puts these employers at a considerable disadvantage with their competitors who do not purchase state-regulated health insurance.
Mandated coverage also limits innovation in plan design and health care service delivery by prescribing what is included in certain plans rather than allowing market forces to determine.
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