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A moratorium on new health plan mandates has passed North Carolina's House of Representatives by an overwhelming majority and appears to have little opposition in the Senate.
A similar bill died in Alabama last month, but only because "we pretty much ran out of time," explains the Senate majority leader there, Tom Butler, a Madison, Ala., pharmacist and primary backer of the bill. He says he introduced the bill at the behest of the local chapter of the National Federation of Independent Business.
Mandates have proliferated as organizations supporting patients with particular diseases have drafted legislation to make sure their preferred treatment is included in health care coverage and have paraded witnesses with dire stories of the consequences of care denied. "It becomes more of an emotional thing than about looking at what the long-term benefits are," explains Rep. E. David Redwine, a Shallotte, N.C. insurance broker and author of the North Carolina measure. The goal of the moratorium is to give lawmakers a chance to weigh the cost of a new demand against the amount of help it will provide. The North Carolina measure would expire Jan. 1, 2004, giving the state time to set up a procedure for conducting a cost-benefit analysis of any new suggested mandates.
The National Federation of Independent Business, which opposes all mandates that are spiking the cost of health insurance beyond the budgets of small employers, says that 15 states already have such procedures in place. Additional moratoriums are likely to be proposed in other states in the next year.
Of course, any moratorium passed by a legislative body can be overridden the next time a majority gets behind a new mandate. Redwine admits as much but counters that having the freeze on the books will give opponents of additional mandates a persuasive new tool, letting them say "let's give this time to work" before rushing into a new coverage demand.
Daniel Moskowitz. North Carolina halting health plan mandates. Business and Health 2001;6:17.