Evaluations of Mandated Health Benefit Proposals in Minnesota

Female doctor talks to her senior adult patient about preventative lab work she should have completed

State health benefit mandates require specific health plans to provide or increase coverage for specific conditions, treatments, health care providers, etc. While health benefit mandates may improve access to care and health outcomes, they may increase the cost of health care or health insurance.

For the Minnesota Department of Commerce, AIR evaluates health benefit mandate proposals, assessing the potential public health, economic, and fiscal impact of proposed legislation to assess the potential value and/or undue burden specific to proposed legislation. 

Together with Actuarial Research Corporation (ARC), which performs the evaluation’s actuarial analysis, AIR produces comprehensive evaluation reports related to complex health care conditions and related services, analyzing relevant economic and medical literature, public comment, and relevant policy. These evaluation reports are delivered to the Minnesota legislature and made available to the public on the Department of Commerce website.

In close partnership with the Minnesota Department of Commerce, AIR and ARC have performed comprehensive evaluations on proposed legislation for a wide variety of emerging topics, such as coverage for GLP-1 agonists and biosimilars, regulation of pharmacy benefit manager pharmacy rebate distribution, and coverage for gender-affirming care. Given the broad range of health conditions represented across the proposed legislation, AIR relies on internal multidisciplinary teams and robust engagement of technical experts to identify appropriate condition-specific outcome measures, health equity considerations, treatments, and related-services. 

Through this work, AIR and ARC use an evidence-based lens to assess potential cost drivers for chronic conditions, potential downstream savings associated with improved access and delivery of specific health services, and public health considerations related to health equity and underserved populations. Developed in close collaboration with other state agencies, such as the Minnesota Department of Health, the evaluation reports reflect both a national- and state-specific lens for the potential impact of proposed health benefit mandates.