FOR YEARS, the public has successfully lobbied state legislators to mandate insurance coverage for everything from fertility treatments to mental-health care. The effect of this has been to provide more comprehensive insurance than in most other states but also to raise costs. Now that the state requires that businesses offer insurance and that individuals buy it, the Legislature should discipline itself by sending all proposals for mandates to an existing panel that weighs their cost and effectiveness.

Providing cost-benefit analyses of proposed mandates is already a responsibility of the Division of Health Care Finance and Policy. While legislators generally request a review by the agency before a mandate becomes law, that should be a requirement.

The Globe reported this week that legislators have filed more than 70 requests for increased coverage for services ranging from children’s hearing aids to the repair of cleft palates. While many insurance policies already include the services in question, some do not.

None of the 32 current mandates is a budget buster, but taken together they do add to premiums. A study last year by the Division of Health Care Finance and Policy found that state mandates beyond those in federal law added about 3 to 4 percent to the cost of insurance. The division reviewed past mandates, and noted that an earlier one for bone-marrow transplants for breast cancer patients “is no longer considered clinically effective.’’ But legislators can ignore these reviews, and the bone-marrow transplant mandate remains on the books.

While medicine improves constantly and legislators should be alert to any advances that insurers are not quick to cover, they should subject all proposed new mandates to the division’s review process – and rescind old mandates that no longer make sense. The delicate balance in the state’s insurance system should not tilt away from affordability.

Found here.