Proposed Mandated Health Insurance Benefits

JLARC staff evaluate proposed health insurance mandates in support of the Special Advisory Commission on Mandated Health Insurance Benefits.

JLARC and Evaluations of Proposed Health Insurance Mandates

In 2006, the General Assembly amended §§ 2.2-2503 and 30-58.1 of the Code of Virginia to direct the Joint Legislative Audit and Review Commission (JLARC) to provide staff assistance to the Special Advisory Commission on Mandated Health Insurance Benefits. The amendments require JLARC to join the State Corporation Commission’s Bureau of Insurance (BOI) in providing staff assistance to the Special Advisory Commission. In particular, JLARC is to assess, analyze, and evaluate the social and economic costs and benefits of any proposed mandated health insurance benefit or mandated provider, and report its findings to the Commission.

JLARC staff reviews of proposed mandates focus on addressing the specific evaluation criteria that have been adopted by the Special Advisory Commission. These criteria are organized around four categories: medical efficacy; social impact; financial impact; and effects of balancing the medical efficacy, social, and financial considerations. JLARC staff use various methodologies to address the criteria including: extensive reviews of medical literature; interviews with medical experts (including experts at Virginia’s State medical schools), providers of medical services, representatives from the insurance industry, and families affected by relevant health issues; analysis of data collected through BOI’s annual survey of health insurers and by other State and federal sources; and reviews of information available from other states and provided by proponents, opponents, and advocacy organizations.

JLARC and BOI staff collaborate at key points throughout the mandated benefit review process. However, each agency conducts an independent evaluation and presents a separate report on each proposed mandate to the Special Advisory Commission.