Testimony to
New York State Senate Health Committee
Out-of-Network Coverage

Presented by
Lev Ginsburg, Esq.
Director of Government Affairs

January 27, 2014

Senator Hannon and Members of the Health Committee;

Thank you for holding this hearing and for the opportunity to share my thoughts on the
impact of out-of-network health benefit mandates on businesses throughout New York. On
behalf of the Business Council’s more than 2,500 members – businesses large and small all
across the state – I wish to submit these comments into the record of today’s hearing.

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. Going forward, new mandates
will have an even greater effect in light of the federal Affordable Care Act’s requirement that
the State pay for any mandates beyond the Essential Health Benefits of the federal act.

Employers and employees want and need choice in the health insurance market. 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 add
both cost and inflexibility to plans, raising prices and limiting variety of plans at the same

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 would essentially remove
any 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.

An out-of-network mandate, like others, would significantly increase the cost of health care.
Unlike in the past however, these costs would not be borne by premium payers alone.
Under the ACA, New York State would have to pay a corresponding amount of any federal
health subsidy for any mandates beyond the Essential Health Benefits. It is of increased
importance that the Legislature show great fiscal discipline and not impose costly coverage
mandates for which there are no revenue sources to pay for them.

Thank you for the opportunity to offer my insight on these important issues. I welcome any
questions or comments you have.

Thank you.

Lev Ginsburg
Director of Government Affairs