🔒Report: CT lawmakers added or changed 18 health insurance benefit mandates over past 11 years

After Connecticut business groups opened the year by calling for greater scrutiny of state-mandated health insurance benefits, a subsequent legislative report found that lawmakers enacted laws creating or changing mandates involving 18 types of benefits over an 11-year period.

And the list continues to grow.

The state Office of Legislative Research in a new report examined public acts enacted between 2015 and 2025 that mandate benefit coverage under fully insured commercial health insurance policies and plans.

OLR identified 18 types of benefits addressed by legislation during that period, although some of the laws modified existing mandates instead of creating new ones.

The report comes as Connecticut employers continue to struggle with rising health insurance costs and as business advocates have questioned whether lawmakers give enough consideration to the cumulative cost of mandated benefits.

In January, business groups told Hartford Business Journal that Connecticut's growing number of coverage requirements was one of many factors putting upward pressure on health insurance premiums. They called for greater scrutiny of proposed mandates and their potential costs.

State mandates apply to fully insured commercial health plans, but generally not to self-insured plans, which are regulated under the federal Employee Retirement Income Security Act (ERISA).

That distinction is significant for employers because larger companies are more likely to self-fund their health insurance benefits, while many smaller businesses purchase fully insured coverage subject to state mandates.

The mandate benefits addressed by legislation over the past decade cover a broad range of health services.

They include mental health and substance-use treatment, autism services, infertility treatment, hearing aids, diabetes treatment, breast and ovarian cancer screening, mental-health wellness examinations, intensive behavioral health services for children, coronary calcium scans and biomarker testing.

Other laws dealt with prosthetic devices, immunization consultations, off-label prescription drugs, anesthesia reimbursement and the repair or replacement of complex rehabilitation wheelchairs.

The legislature added more coverage requirements during its 2026 session.

Public Act 26-33, signed into law by Gov. Ned Lamont in May, generally requires certain individual and group health insurance policies to cover treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, known as PANDAS, and pediatric acute-onset neuropsychiatric syndrome, or PANS. The disorders can cause children to suddenly develop severe behavioral or neurological symptoms, sometimes following an infection.

That law also requires coverage for prosthetic devices designed exclusively for athletic purposes, as well as for scalp-cooling systems used during chemotherapy. It also expands the state's existing infertility coverage mandate. The requirements all take effect on Jan. 1, 2027.

As with earlier state mandates, these new requirements generally do not apply to self-insured employer health plans.

The debate over mandates pits concerns about insurance affordability against efforts to ensure patients have access to treatments and services that advocates argue should be covered by health plans.

It also raises the question of how much the requirements collectively contribute to premiums.

The OLR report catalogs the legislation enacted over the 11-year period, but it does not calculate the cumulative financial impact of those mandates on premiums paid by employers and consumers in Connecticut.