Looking into the Crystal Ball: Preparing for the Essential Health Benefits
Held December 8, 2011
At the NASHP Annual Conference in October, panelists discussed the potential implications of the Essential Health Benefits (EHB) and actions states could take to prepare. Now, with the release of the Institute of Medicine report of recommendations to HHS, states may still have more questions than answers. What are the implications of the proposed EHB package for the Exchange and Medicaid? What are the effects on the commercial insurance market and for existing state benefit mandates? What flexibility will exist for states to depart from a federal definition?
While the ACA establishes important new parameters for insurance coverage, states will have some key decisions to make where federal guidance leaves off. States retain control over benefit mandates in the fully-insured small group and individual markets, as well as in state employee and retiree plans, although they will have to pay for any benefits beyond the federal essential benefits package. States will continue to have options for benefits in Medicaid, CHIP, and a state basic health plan, if implemented, but may want to align benefits in these programs with benefits in plans available through the exchange.
This State Refor(u)m webinar tackled these issues. Presenters helped states identify how to get started on benefit design, and panelists provided context and insights on how to interpret the upcoming HHS guidance on the EHB package.
Moderator:
Alan Weil, Executive Director, National Academy for State Health Policy
Speakers:
At the NASHP Annual Conference in October, panelists discussed the potential implications of the Essential Health Benefits (EHB) and actions states could take to prepare. Now, with the release of the Institute of Medicine report of recommendations to HHS, states may still have more questions than answers. What are the implications of the proposed EHB package for the Exchange and Medicaid? What are the effects on the commercial insurance market and for existing state benefit mandates? What flexibility will exist for states to depart from a federal definition?
While the ACA establishes important new parameters for insurance coverage, states will have some key decisions to make where federal guidance leaves off. States retain control over benefit mandates in the fully-insured small group and individual markets, as well as in state employee and retiree plans, although they will have to pay for any benefits beyond the federal essential benefits package. States will continue to have options for benefits in Medicaid, CHIP, and a state basic health plan, if implemented, but may want to align benefits in these programs with benefits in plans available through the exchange.
This State Refor(u)m webinar tackled these issues. Presenters helped states identify how to get started on benefit design, and panelists provided context and insights on how to interpret the upcoming HHS guidance on the EHB package.
Moderator:
Alan Weil, Executive Director, National Academy for State Health Policy
Speakers:
- Chris Koller, Health Insurance Commissioner, Rhode Island
- Carolyn Ingram, Executive Vice President, Center for Health Care Strategies
- John Lewis, Associate Director, California Health Benefits Review Program
- Ben Steffen, Acting Executive Director, Maryland Health Care Commission.
Elizabeth Cronen also highlighted how State Refor(u)m can help states get started on benefit design. Has your state done benefit design work that you don’t see represented here? Share your work if your state has, for example:
- Assessed benefit packages
- Looked at current state benefit mandates
- Decided to pursue continuity in benefit design
Download the slides or watch the webinar recording below:
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– See more at: https://www.statereforum.org/webinars/looking-into-the-crystal-ball-preparing-for-essential-health-benefits#sthash.PuqN2xyP.dpuf
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