Legislative Memo

Lev Ginsburg
Director of Government Affairs
T 518.465.7511


S.1846 (Hannon) / A.3734 (Rosenthal)



Mandating every insurer to offer, both inside and outside of the exchange, out-of-network coverage in at least one policy option and as an optional rider.



May 9, 2016


The Business Council of New York State opposes S.1846 (Hannon) / A.3734 (Rosenthal) which would mandate every health insurer in the state to offer, both inside and outside of the health exchange, out-of-network coverage as a rider.

Depending on how you count what a mandate is; New York has over four dozen. The incremental and steady growth of mandates over the years has had a significant impact on the increased costs of health insurance in New York State. A healthy market with a variety of coverage options is the only way to ensure that New Yorkers can purchase insurance that fits both their health care needs and their budgets. Mandates such as this add both cost and inflexibility to plans, raising prices and limiting variety of plans at the same time.

Robust health-care networks are the cornerstone to controlling healthcare costs and promoting health and wellness. Legislation that would mandate all health insurers to offer coverage for all services performed by out-of-network providers, even as a rider, removes leverage health plans have to negotiate with providers to participate as part of networks. There is little doubt that this would seriously weaken existing networks and result in significantly increased health insurance premiums for New Yorkers, employees and employers alike.

Another out-of-network mandate would significantly increase the cost of health care. Given New York’s slow economic recovery, it is of increased importance that the Legislature show great fiscal discipline and not impose costly coverage mandates that New York businesses cannot afford. Instead, we should be focused on issues driving health care costs upwards.

For these reasons, The Business Council opposes S.1846 (Hannon) / A.3734 (Rosenthal).