I. Background

Alcohol exclusion laws were passed in the late 1940s. They were to discourage people from abusing alcohol.

This saves insurance companies money. That’s because they can deny alcohol-related medical claims. These claims could include traffic-related or any other alcohol-related injury. But there was great hope that they would reduce drunk driving.(1)

The logic seemed reasonable. People would be less likely to drive drunk if insurance companies could deny their claims for that reason.

II. Unintended Consequences

Unfortunately, there is no evidence that alcohol exclusion laws reduce drunk driving. But they do discourage hospitals from testing crash patients for alcohol. That’s because insurance companies can refuse to pay doctors and hospitals for treating patients who have alcohol in their bodies. In short, alcohol testing would lead to lower doctor and hospital income.

The George Washington University Medical Center explains

The Alcohol Exclusion Law helps drunk drivers escape detection and avoid taking personal responsibility for their drinking problem. This makes it more likely that drunk drivers will drive drunk again. That adds to the cost of the health care system. And it makes it more difficult for individuals who have problems with alcohol or drugs to access the treatment they need.(2)

In 2000, 40 states had alcohol exclusion laws. One state prohibited alcohol exclusion. In 2015, 25 states permitted permitted exclusion and 17 prohibited it.(3)

III. Opposition to Alcohol Exclusion Laws

Not surprisingly the insurance industry supports alcohol exclusion laws. They save the companies vast sums of money. However, the National Association of Insurance Commissioners voted unanimously to recommend the repeal of alcohol exclusionary laws. That’s  the professional organization of those who regulate insurance companies.

Other groups that support the repeal of alcohol exclusion laws include these.

• American College of Emergency Physicians.
• National Conference of Insurance Legislators.
• American Medical Association.
• American Public Health Association.
• Mothers Against Drunk Driving.
• American Bar Association.(4)

IV. Laws are Counterproductive

Alcohol exclusion laws are another example of legislation that’s counterproductive. Here’s why.

Studies have shown that individuals who receive brief alcohol counseling in emergency rooms or trauma centers have 48 percent fewer readmissions to the hospital and 28 fewer drinks per person per week than patients who do not receive counseling. For every $1 spent on alcohol counseling for injured patients, hospitals can expect to save $3.81. By discouraging screening and treatment, the Alcohol Exclusion Law leads to more hospital readmissions, DUIs, alcohol-related traffic infractions, alcohol-related arrests, and injury-related hospital readmissions.(5)

V. State Laws

A. Alcohol and Drug Exclusion Clauses Permitted

• Alabama
• Alaska
• Arizona
• Arkansas
• Delaware
• Florida
• Georgia
• Hawaii
• Idaho
• Kansas
• Kentucky
• Louisiana
• Maine
• Mississippi
• Missouri
• Montana
• Nebraska
• New Jersey

B. Alcohol and Drug Exclusion Clauses Prohibited

• California
• Colorado
• Connecticut
• District of Columbia
• Illinois
• Indiana
• Iowa
• Maine
• Maryland
• Nevada
• North Carolina
• North Dakota
• Ohio
• Oregon
• Rhode Island
• South Dakota
• Washington

C. Alcohol and Drug Clauses Neither Permitted nor Prohibited

• Massachusetts
• Michigan
• Minnesota
• New Hampshire
• New Mexico
• Oklahoma
• Texas
• Utah
• Vermont
• Wisconsin
•  New York
•  Pennsylvania
•  South Carolina
•  Tennessee
•  Virginia
•  West Virginia
•  Wyoming 

It appears that alcohol exclusion laws may actually increase drunken driving instead of reducing it.

Note. Alcohol exclusion laws are typically found in the Uniform Accident  and Sickness Policy Provisions (UPPL) of a state.

VI. References & Resources

References

1. Fact Sheet.  George Washington University Medical Center.  Ensuring Solutions to Alcohol Problems web site.
2.  Alcohol Policies Information Service.
3. Fact Sheet.
4. Ibid.
5. Ibid.

Resources

• American Medical Association Advocacy. Supporting Repeal of the Uniform Accident and Sickness Policy Provision Law. Chicago: AMA, 2004.
• Fornili, K., and Goplerud, E. Trauma centers and insurance exclusion laws: Unintended consequences and missed opportunities.  J Addict Nurs, 2006, 17(3).
• Hungerford, D., and Pollock, D. Alcohol Problems among Emergency Department Patients. Atlanta: CDC, 2012.
• Poland, A. Are patients at U.S. hospitals routinely screened for alcohol use? J Addict Med, 2008, 2(1), 51-53.
• Rivara, F., et al.  Screening trauma patients for alcohol problems: Are insurance companies barriers?  J. Trauma, Inj, Infect Crit Care, 2000,  115,  48.
• Son, C.-H. Differences in alcohol-impaired driving behaviors from the connection between alcohol consumption patterns and drinking and driving laws. Int J Econ Perspect, 2014, 8(3), 52-63.
• Teitelbaum, J, et al.    State laws permitting intoxication exclusions in insurance contracts: implications for public health policy and practice.  Pub Health Reports, 2004, 119, 585.