State Mandated Benefits

HEHS-96-125R: Published: Apr 15, 1996. Publicly Released: Apr 15, 1996.

Additional Materials:


Office of Public Affairs
(202) 512-4800

Pursuant to a congressional request, GAO provided information on state regulation of health plans, particularly mandated health insurance benefit laws. GAO noted that: (1) the number and type of mandated benefits vary by state, but they range from 6 to 39 and average 18 per state; (2) states most frequently mandate the coverage of preventive care and some states mandate coverage of services by nonphysician providers; (3) assessing the impact of mandated benefits is difficult because each benefit varies depending on state law and employer practices; (4) studies have shown that mandated-benefit costs vary by state, ranging from about 5 percent to 22 percent of claims costs; (5) mandated-benefit costs are generally higher in states with more mandated benefits and higher-cost mandated benefits; (6) mental health and substance abuse services are the most expensive benefits; and (7) self-funded health plans often cover commonly mandated benefits, even though they are exempt from state regulation, and there is little difference in claims costs between self-funded and fully-insured heath plans.

Oct 18, 2017

Aug 24, 2017

Jul 20, 2017

Apr 24, 2017

Dec 20, 2016

Nov 21, 2016

Sep 14, 2016

Sep 8, 2016

May 5, 2016

Looking for more? Browse all our products here