Tag: essential health benefits

States Revisit Essential Health Benefit Requirements, but Have Little Data on Consumers’ Experiences

Federal Affordable Care Act rules require the states to revisit the standard scope of benefits for individual and small business health plans – called essential health benefits or EHB – and determine whether revisions are needed. In a new blog post for the Commonwealth Fund, CHIR experts examine how the states approached this task, and what it might mean for consumers.

Activity Afoot on Essential Health Benefits

Did you know states need to select their Essential Health Benefits (EHB) benchmark plan for 2017 in just a few weeks? If not, JoAnn Volk will tell you about the process underway and how advocates can get involved.

HHS Proposes EHB Rule Changes

The federal Department of Health and Human Services recently published a proposed regulation that signals some potentially helpful changes to the requirement that health insurers cover a set of essential health benefits. Our colleague at Georgetown University’s Center for Children and Families, Joe Touschner, offers this overview.

Implementing the Affordable Care Act: Revisiting the ACA’s Essential Health Benefits Requirements

Within the next several months, federal officials must decide whether to maintain or modify their “transitional” approach to implementation of the Affordable Care Act’s essential health benefits (EHB) requirements. In a new issue brief for the Commonwealth Fund, CHIR researchers examine how states have exercised their flexibility under the current EHB rules.

New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures

Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.

New Federal Guidance Helps Protect People from Discrimination in Benefit Design

In response to actions by some health plans to impose benefit-specific waiting periods for coverage of serious health conditions, such as organ transplants, the Obama Administration recently issued guidance to prohibit the practice and protect consumers from discriminatory benefit design. Georgetown Law Center’s Sandy Ahn reviews the new guidance and the impact for consumers in this guest post.

More New Resources Available to State Regulators

A set of new tools for state insurance regulators, as well as updated versions of some older resources, have recently been posted on the Robert Wood Johnson State Health Reform Assistance Network (State Network) web site. CHIR faculty Sally McCarty, David Cusano, and Max Farris, who serve as technical assistance professionals (TAPS) in the State Network Program, developed the new resources. Sally McCarty describes them here and provides information about an upcoming Webinar to introduce them and demonstrate their use.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.