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Insurance mandates are bad health care policy

Hundreds of bills have been introduced in the North Carolina General Assembly since the session started over two months ago. The bills deal with a wide variety of issues such as tax reform, school choice, and election reform. With so many bills, one would indeed find some good ones and some bad ones. I’m going to highlight two bad bills in this blog post.

The two bills are HB 149, Improving Access to Care Via Telehealth, and HB 329, Chiropractic Care Copayment Parity. Both of these bills deal with health insurance benefit mandates. Many legislators are rightly concerned about health insurance coverage, health care access, and the cost of health care. There are many ways to address the formerly stated concerns, but these two bills are not it.

HB 149, Improving Access to Care Via Telehealth, is similar to bills previously filed in the General Assembly over the past several legislative sessions. The bill deals with coverage and payment parity requirements for insurers who operate in the state and provide telehealth benefits. At its core, the bill would require insurers to reimburse providers for any service provided over telehealth that would usually be covered for in-person care. This is referred to as “coverage parity” and has been used by legislators in several states across the country to increase the use of telehealth.

While increasing the use of telehealth usage is a worthwhile goal, insurance mandates are a poor way of going about it and could lead to unintended consequences that run counter to telehealth’s goals. First, choosing to mandate something that the market will naturally encourage intrudes on free enterprise. Private insurers and providers are in a much better position to enter into contracts about what telehealth services should be covered in a given insurance plan than the General Assembly. Second, not all health care services are appropriate or even possible via telehealth. Prohibiting insurers from excluding coverage for some services provided via telehealth could lead to inappropriate billing from providers leaving insurers to pay unnecessary claims.

The second bill, HB 329, Chiropractic Care Copayment Parity, prohibits an insurance company from placing a limit on treatment and the level of coverage an insurer can provide to the insured for chiropractic services. Not only does it prohibit limiting coverage, but it also prohibits charging a higher copayment to the insured when receiving chiropractic services for comparable treatment from a primary care physician, physician assistant, or nurse practitioner. This bill would drastically increase health insurance spending under the guise of expanding primary care practices by forcing insurers to pay for chiropractic care at the same rate as primary care.

These bills represent the further government meddling into the private health care market in which insurers and providers negotiate insurance benefits and provider reimbursements. Again, legislators are right to be concerned about health care costs and access but mandating additional coverage benefits like the ones in HB 149, and HB 329 is the wrong prescription.

Jordan Roberts / Government Affairs Associate

Jordan joined the Locke Foundation in the summer of 2018 as Health Care Policy Analyst. He analyzes state and national health policy issues with an eye toward removing governm...