Upcoming Sessions
Essential Health Benefits: An Overview for State Legislators
Tuesday, Feb. 28, 2-3 p.m. EST
Sherry Glied, assistant secretary for Planning and Evaluation, U.S. Department of Health and Human Services, will discuss the recent federal decision to allow state policymakers to set “essential health benefits.” These benefits are the minimum package of benefits for all individual and small group insurance sold in states after January 2014. The Department of Health and Human Services estimates these plans will cover 30 million people, some of whom may currently be covered by plans with fewer benefits.
The federal Affordable Care Act requires that individual and small group insurance sold in states after Jan. 1, 2014, both inside and outside the health insurance exchange, include a minimum package of essential health benefits. In December, Secretary Kathleen Sebelius announced that rather than establish one federally designated set of essential health benefits, her department will give states the flexibility to select a benchmark plan from among designated existing plans in the state. States also will have flexibility around cost-sharing – whether and how much consumers can be charged in co-payments and deductibles. Federal law requires a minimum package of benefits in 10 specific coverage areas, including maternity care, prescription drugs, mental health care, rehabilitative and habilitative services, and pediatric services with oral and vision care.
To read more about essential health benefits and the new federal policy, see this Dec. 20, 2011, CSG blog post.
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