One reason for the high cost of insurance lies in the mandates governing the insurers. Mandates are politically inspired and government-backed add-ons to insurance which raise the cost of insurance for everyone and blocks access for those without insurance.

The Council for Affordable Health Insurance (CAHI) has studied health insurance mandates in the fifty states. As of 2006, states had more than 1,800 mandated benefits requiring insurers to provide coverage for treatments ranging from mental illness, maternity or any number of other maladies. In this year’s session the Kansas legislature heard testimony to provide a mandate for bariatric surgery.

A 1999 study by economists Gail Jensen and Michael Morrisey of the Health Insurance Association of America showed that "as many as one in four individuals who are without coverage are uninsured because of the cost of health insurance mandates."

What is the problem with mandates? It forces insurance companies to provide benefits for people who don’t want them and yet are still forced to pay for them. "Mandating benefits," according to CAHI, "is like saying to someone in the market for a new car, if you can’t afford a Lexus loaded with options, you have to walk. Having that Lexus would be nice . . . but drivers with less money can find many other affordable options, whereas when the price of health insurance soars, few other options exist."

In CAHI’s study of the states, Kansas falls somewhere in the middle of the pack when it comes to mandates. Kansas has thirty-seven insurance mandates, eighteen catalogued as benefits and five for covered persons. Out of the eighteen benefit mandates only five are mandated by fewer than half the states (bone mass measurement, diabetes self-management, mastectomy, mastectomy stay, maternity). Out of that group only bone mass measurement is mandated by fewer than fifteen states.

The thirty-seven insurance mandates make Kansas about average. Idaho, as of 2007, had 16 mandates (on the low end) while Minnesota had 63.

Mandates are costly and too many mandates make health insurance more expensive thereby contributing to problems with access. One way to improve the situation is to allow the purchase of health insurance across state lines. If Idaho has fewer mandates than Kansas, then allow an average 30 year old male to purchase health insurance in Idaho (provided it meets the requirements of the Kansas Department of Insurance as a product salable in the state) to help lower his costs.