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State Lawmakers Rising Up Against Mandatory Health Insurance

Joe Cantlupe, for HealthLeaders Media, February 4, 2010

State legislatures are getting fired up over health insurance.

In Virginia on Monday, the conservative Tea Party successfully spurred lawmakers in Richmond to endorse measures opposing any proposed federal government healthcare insurance mandates. On Tuesday, Kansas joined the fray, also opposing any insurance mandate. At least 31 states have enacted similar measures and several more are expected to follow.

"I see this as a political protest with positions being staked out, the battle lines being drawn," says Mark A. Hall, a professor of law and public health at Wake Forest University, regarding the states' actions. "The states are subject to federal law and that won't hold up in court," Hall says bluntly.

Health insurance leaders are watching the state lawmakers' decisions—and they are not happy about it.

"Experience in the states has shown that market reforms without a personal coverage requirement can have significant unintended consequences, including higher healthcare costs for current policyholders," says Robert Zirkelbach, spokesman for America's Health Insurance Plans, the insurance lobby.

Despite the fanfare, other legal experts agree with Hall that the states' decisions don't appear to have much legal clout. State representatives say otherwise.

Altogether, 35 states are expected to file amendments to their state constitutions or statutes rejecting health insurance mandates, according to the American Legislative Exchange Council, a nonprofit group that promotes limited government. It is coordinating the state effort.

Under the state anti-mandate plans, each state would assert a state-based right for people to pay medical bills from their own pocketbooks and prohibit penalties against those who refuse to carry health insurance. The movement began to pick up steam after the Massachusetts election gave Senate Republicans the filibuster power to halt healthcare reform legislation.

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