Show Me the Data: Looking at New Health Benefit Mandates

The legislature’s Insurance Committee approved several health benefit mandates this week, even though the long-term cost and benefit impacts of many of them are unknown.
Adding more health benefit mandates–that is, treatments, procedures or services that must be covered–will increase the cost of health insurance premiums in Connecticut. So it’s vital that every proposal has enough good data to justify their consideration.
The committee approved, for example, two new mandates (SB 7 and SB 15) that currently lack enough data for a long-term cost-benefit analysis. Without the appropriate data, lawmakers should refrain from acting on these mandates at this time.
On the other hand, SB 21 which would require coverage for abuse-deterrent pain medications on the same basis as non-abuse deterrent versions, is based on data-driven policy.
The Food and Drug Administration (FDA), in its approval process for abuse-deterrent opioids, has relied on study data showing these medicines’ measurable impact on reducing opioid abuse by patients–and therefore in reducing costs to the healthcare system.
The committee recently held a public hearing on preliminary language of the bill and this week voted to fully draft the bill.
Another bill (SB 5) addresses telemedicine–in general telemedicine is an effort to use technology such as video, email and other modes of communication besides in-person visits to care for patients.
While many–including CBIA–agree that telemedicine can have a positive, long-term impact on healthcare cost and quality, the bill approved by the committee hamstrings growth in this important area.
Many in the committee voiced their concerns with the bill but said they wanted to see it continue through the legislative process. One of our main concerns is how the current bill dictates the use and billing of telemedicine.
With many stakeholders–including patients, doctors and insurers–already participating in telemedicine, efforts to limit its growth and expansion by dictating the payment and access at this early stage may be detrimental to its full potential.
CBIA will continue to closely monitor health benefit mandates before the Insurance Committee and assess each bill for its cost-benefit impact.
For more information, contact CBIA’s Jennifer Herz at 860.244.1921 | jennifer.herz@cbia.com | @CBIAjherz