In the wake of the recent Alabama Supreme Court ruling related to in vitro fertilization clinics/practices, policymakers are likely to respond by overreacting and making hasty policy decisions.
Suggesting a new federal benefit mandate is one of those ill-advised ideas.
A federal benefit mandate for IVF would not only raise the cost of health care coverage, but it would further entrench efforts by the Left to consolidate federal control over health care that intensified under Obamacare.
All health insurance benefit mandates—whether enacted at the state or federal level—increase the cost of health insurance, thus harming consumers. While the same arguments apply to state benefit mandates, enacting a federal benefit mandate would be worse because of its broader scope—applying not only to health insurance regulated by any state, but also to employer self-insured plans and federal health care programs.
Indeed, one of the biggest problems with Obamacare was that it preempted state regulatory authority to create a federal health insurance benefit floor called “Essential Health Benefits” for the individual and small-group health insurance markets.
Obamacare’s EHB requirements have been among the factors responsible for increasing the cost of coverage in those markets.
Mandating coverage for what are essentially elective treatments, such as infertility treatments or cosmetic surgeries, raise other practical issues and can entail additional costs. The cost and therefore premium impact could vary widely, depending on the specifics of the mandate with respect to factors such as technologies and services that must be paid for and the circumstances to which the benefit applies and the frequency with which enrollees can use the services.
Today, according to an analysis by Forbes, the 2024 monthly premium cost of an average Obamacare plan for a single 40-year-old individual is $469, and for a 40-year-old couple, it is $937. If that couple also has a child, the monthly premium is $1,214, and if they have two children, it’s $1,491. That translates into $17,892 in annual health insurance premiums for a family of four.
Furthermore, in addition to premiums, there is also the cost of deductibles and other enrollee co-payments. The Kaiser Family Foundation estimates that the average weighted deductible for Obamacare plans is $3,057 and can reach $7,258 for certain plan types. Some individuals may qualify for subsidies to offset premiums and cost sharing, but not all.
A federal benefit mandate would also affect employer-sponsored coverage. In its 2023 annual Employer Health Benefits survey, the Kaiser Family Foundation reports that “[a]nnual premiums for employer-sponsored family health coverage reached $23,968 this year, with workers on average paying $6,575 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,735 for single coverage.”
Adding new federal benefit mandates would further increase the already high cost of health insurance coverage.
From a larger health policy perspective, conservatives have long warned that efforts to consolidate control over health care through the federal government is the liberal playbook for achieving a single-payer, government-run health care model in the U.S.
The misguided federal one-size-fits-all response to COVID-19 should serve as a cautionary example to policymakers about the dangers and costs associated with relying on federal bureaucrats to micromanage America’s health care system.
When it comes to health insurance coverage, Congress should instead focus on reducing the cost of health care for Americans and restoring state authority over the regulation of health insurance. Any new federal benefit mandates would do the opposite.
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