The cost question is especially timely given last week's report by the CMS actuary that found healthcare spending is accelerating in some ways after enactment of the Patient Protection and Affordable Care Act. The need to control ever-growing healthcare costs was a major justification for the law. So are the latest requirements on private insurers going to help bend that cost curve?
If you were thinking of asking the department that issued the new rules, don't bother.
A Monday press call about the new private insurance rules by HHS officials was long on talk of equality and short on cost details. HHS officials danced around several attempts by reporters to nail down the cost of the new benefit.
“For right now we're sticking to the idea that the increase is going to be very small, given that the majority of the plans in the employer world are already covering these services,” said Mayra Alvarez, director of public health policy in the Office of Health Reform at HHS. “We don't expect that increase to be very large,”
But earlier in the same event, the HHS officials touted the new coverage requirements as likely affecting 34 million women (and an unspecified number of adolescent girls) as soon as 2013. So how can millions of people obtain free services and then have no cost worth mentioning or finding out?
The HHS had no more details for me when I followed up looking for cost projections.
The biggest insurance trade group, America's Health Insurance Plans, told me it doesn't have an estimated cost for the new benefits, either. However, they were not the ones who generated the new requirements.
Of course, the HHS and prevention advocates counter that all this talk of costs overlooks the possible savings that preventive healthcare services offer. It's true that some preventive services are net cost savers, but others are net cost-drivers because false positives can then result in expensive and unnecessary treatments.
One cost example among the latest overage requirements, the mandated coverage of birth control services (one of eight new categories of soon-to-be free preventive services), was estimated to add up 3% to the cost of health insurance policies in the 28 states that mandate it, according to research by the Council for Affordable Health Insurance.
Alvarez disputed it would cost that much for policyholders, but HHS would provide no data to contradict it.
So, who knows the total cost of the latest mandates? But as the Council for Affordable Health Insurance, an industry research and advocacy group, pointed out in its 2009 report on state mandates: “Although most mandates only increase the cost of a policy by less than 1%, 40 such mandates will price many people out of the market.”
You can follow Rich Daly on Twitter @MHRdaly.