costs. CBO estimated that inpatient hospital days would increase by approximately 400,000 days
and follow-up care would increase by approximately 200,000 visits annually.
CBO estimated that the additional utilization due to the implementation of S. 969 would
have resulted in an aggregate increase in insured costs of 0.06 percent for all employment-based
and individually purchased health plans. CBO assumed that, in response to the increase in
premiums, employers and individuals may choose to reduce coverage or drop benefits. Although
some plans may make slight reductions in overall benefits to offset this minimal increase in cost,
the Departments believe that virtually no employers will drop health coverage entirely or drop
coverage for hospital stays in connection with childbirth. After taking behavioral responses into
account, CBO estimated that employer contributions for health insurance would only rise by
about 0.02 percent and most of that increase likely would be passed back to employees in the
form of reduced wages.
Applying the same 0.06 percent increase to the cost of health insurance for covered
employees of nonfederal governmental plans would raise expenditures. However, CBO assumed
that most of these costs would be passed back to employees.
Apart from increased benefit costs for their employees, States may face additional costs
for enforcing NMHPA’s requirements on issuers of health insurance in the group and individual
markets. Because States currently regulate the private-sector health insurance market, CBO
assumed that the increase in costs would be marginal. However, in cases where States fail to
implement NMHPA or their own laws meeting the criteria specified in NMHPA, the federal
government assumes enforcement authority. Depending on the need for federal enforcement,
some of the aforementioned costs may be shifted to the federal government.