One proposal before the Legislature would require health insurers to cover the full cost of hearing aids for children. Another would require them to pay for treatments to fix cleft palates. Still another would mandate payment for wigs after hair loss from cancer and other illnesses.

Precisely what is driving the recent spike in proposed mandates is unclear. But some legislators and insurers believe that patient advocates are racing to get their health concerns covered by law before the state’s system for paying doctors and hospitals is overhauled. A commission recommended earlier this month that the state dramatically change how providers are paid, and legislators plan to hold hearings on the issue in September.

New mandates could raise the cost of state-subsidized insurance and increase premiums for private employers and their workers, although it’s not yet clear by how much. Given the state’s budget woes, it’s uncertain how many of the bills will make it into law.

But the proposals to require coverage of everything from aquatherapy to vitamins for certain patients raise broader questions about where legislators should draw the line - and whether they should be the ones making delicate decisions that require balancing cost with patient needs.

Some ethicists and economists suggest that such complex and high-stakes choices should instead be made by panels of healthcare specialists who are appointed by lawmakers, as is done in many other developed countries.