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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
5049.0: Wednesday, December 14, 2005 - 9:30 AM

Abstract #109946

State mandated benefit review laws: The growth of evidence-based health insurance policy

Nicole M. Bellows, MHSA, Helen A. Halpin, PhD, and Sara B. McMenamin, PhD, MPH. Center for Health and Public Policy Studies, University of California, Berkeley, 140 Warren Hall, #7360, Berkeley, CA 94720-7360, 510-643-1675, nstark@berkeley.edu

The growth of state mandated health insurance benefits has given rise to concerns regarding the effects of these mandates on increasing premium costs and access to health insurance. This paper examines the laws states have enacted to review mandated health insurance benefits and analyzes variations of the laws with regards to who has the responsibility and authority to conduct the reviews and the criteria they must use to evaluate the mandated benefits, including public health criteria. A total of 26 states were found to have a mandated benefit review (MBR) law in place. While the oldest MBR laws date back to the mid-1980s, almost half of the MBR laws have been enacted since 2000. This recent growth in MBR laws point to an increased reliance on systematic reviews of published research by health policy makers in determining whether health insurance mandates are beneficial to state populations. The paper describes four different reviewer categories and five types of evaluation criteria specified in the current MBR laws. After discussing the strengths and weaknesses of the various approaches utilized in the MBR laws, we conclude that the unique aspects of the state university system used in the California law can serve as a potential model for other states.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

Science in Public Health Law And Policy: Evidence For Vaccines, Drugs, Stem Cells And Insurance

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA