Mandates may have caused nearly 300,000 to lose health insurance
State health insurance mandates may have caused up to 297,500 Ohioans to become uninsured in the mid-1990s, according to a study produced by the Galen Institute. [1]
Ohio’s uninsured population grew from 1,008,500 to 1,306,000 between 1990 and 1996. [2] State health insurance mandates, which were passed by the Ohio General Assembly, went into effect in January 1993.
The laws passed by the Ohio General Assembly imposed mandates and regulations in the small-employer and individual health care markets. [3]
Fifteen other states passed similar regulations during the period between 1990 and 1996. [4] Each of these states saw more people become uninsured and fewer people covered by private insurance:
- the 16 states (including Ohio) which passed health insurance regulations in the 1990s experienced a 25.6 percent increase in the number of uninsured. The other 34 states experienced an increase in the number of uninsured of just 7.2 percent.
- the 16 states which passed insurance regulations saw a 6.7 percent decrease in the number of privately insured while the 34 states which did not enact such health insurance regulations saw a decrease of just 3.3 percent.
Ohio saw the number of uninsured increase 24.3 percent and the number of privately-insured decrease 6.3 percent during the same period. [5]
The Ohio legislature is currently considering several other health care mandates, including mental health parity legislation. [6] The Buckeye Institute analyzed mental health parity legislation in Ohio in a report released May 25, 1999. It estimated that between 30,100 and 119,600 Ohioans could lose or drop their health insurance if a mental health parity mandate is passed. [7]
Notes
[1] Melinda L. Schriver and Grace-Marie Arnett, "Uninsured Rates Rise Dramatically in States with Strictest Health Insurance Regulations," Heritage Foundation Backgrounder No. 1211 (Washington, D.C.: The Heritage Foundation, August 14, 1998). Produced by the Galen Institute, a not-for-profit institute specializing in health and tax policy research based in Alexandria, Virginia.
[2] Point data are averages of 1989-1990, and 1995-1996. According to the report, averages for the 16 states analyzed in the study were used for two reasons: "first, due to the difference in date of enactment and effectiveness (typically implemented incrementally) and second, to avoid contaminating the pre- and post-reform findings with selection effects" (p. 44). Data are from U.S. Bureau of the Census Current Population Survey data from 1989 through 1996.
[3] Regulations such as guaranteed renewal, guaranteed issue in at least one plan, limits on pre-existing condition exclusions, and certain premium rate restrictions were implemented. In addition, carriers were limited to charging premiums to individuals that could not exceed 2.5 times the highest rate charged to any other individual with similar case characteristics.
[4] The Galen Institute report selected the 16 states based on the identification of states that had passed both small-employer market regulations and mandates between 1990 and 1994 and individual market regulations and mandates by early 1995. States passing small-employer market regulations and mandates in that period were identified in the U.S. General Accounting Office report Health Insurance Regulation: Variation in Recent State Small Employer Health Insurance Reforms (GAO/HEHS-95-161FS, June 12, 1995). States passing individual market regulations and mandates were identified in the GAO report Private Health Insurance: Millions Relying on Individual Market Face Cost and Coverage Trade-Offs (GAO/HEHS-97-8, November 26, 1996). To be included in the Galen Institute report, states must have been included in both GAO reports. The 16 states included in the reports are: Idaho, Iowa, Kentucky, Louisiana, Maine, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Utah, Vermont, Washington.
[5] The percentage increase in the number of uninsured is found by the percentage point change in the number of uninsured from 1990-1996 divided by the percentage of uninsured in 1990. The Ohio Department of Health estimates that 1,216,802 Ohioans were uninsured in 1995, which is 6.8% lower than the average provided by the U.S. Bureau of the Census for 1995-96. The Department of Health estimates exclude traditional college students and individuals in adult correctional facilities. Estimated by Ohio Department of Health, "Synthetic Estimation of Uninsured Rates by County in Ohio" (September 1997).
[6] As of May 1, 1999, the pending health care mandates are HB 53 (Olman, R) on mental health parity, HB 151 (Mottley, R) on insurance coverage appeals, HB 173 (Winkler, R) mandating coverage of anesthesia, HB 218 (Krebs, R) on mandating coverage of infant formula as a "basic need," HB 253 (Beatty, D) mandating that health care providers and insurers restrict fees charged for providing medical records, HB 272 (Britton, D) mandating coverage of osteoporosis, SB 80 (Latell, D) mandating coverage of second opinions for mastectomy procedures, and mandated coverage of contraceptives HB 42 (Schuck, R).
[7] James A. Damask, "Mental Health Meddling: An Analysis of Mental Health Parity Legislation in Ohio," Policy Brief (Dayton, Ohio: The Buckeye Institute for Public Policy Solutions, May 25, 1999). The complete report is available on-line at www.buckeyeinstitute.org.
