By Stacey Pogue, Vrudhia Raimugia, Justin Giovannelli, Kevin Lucia
To address longstanding gaps in coverage, the Affordable Care Act requires plans sold in the individual and small-group health insurance markets to cover a comprehensive set of “essential health benefits” (EHB) that reflect typical employer-based coverage. States define the exact scope of these benefits within federal parameters by designating an EHB “benchmark” plan. Federal rules effective in 2020 and 2026 give states additional flexibility to update their EHB benchmark plans, so coverage can keep pace with consumer needs and medical advances.
In a new issue brief for the Commonwealth Fund, CHIR’s Stacey Pogue, Vrudhi Raimugia, Justin Giovannelli, and Kevin Lucia explore how states have used this flexibility to expand EHB to address consumers’ needs or advance state health policy goals. The brief describes how recent rules changes and grant awards will help states and what challenges remain for states and consumers. You can read the full issue brief here.
2 Comments
Don’t make a move before reading these gold IRA reviews; they provide valuable insights into this type of investment.
This post highlights some important steps states are taking to improve coverage by updating their benchmark plans. One of the things I really appreciate is the focus on addressing the gaps in coverage, especially when it comes to services like mental health and substance use. These are areas that have often been overlooked in the past, so it’s great to see states prioritizing them. I hope that these state-level updates will serve as a model for future healthcare reforms at the national level as well.