U.S. Chamber of Commerce Urges HHS to Keep Health Benefits Affordable

The U.S. Department of Health and Human Services (HHS) is developing a final rule on the essential health benefits that individual and small-group plans must cover as part of the 2010 healthcare reform law. The “Essential Health Benefits Bulletin” as issued by Department of Health and Human Services’ (HHS’s) Center for Consumer Information and Insurance Oversight (CCIIO) on December 16, 2011 has concluded under the Affordable Care Act that the mandated all health insurance plans are required to offer a core package of items and services known as “Essential Health Benefits (EHBs).”  HHS has identified 10 ESB categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services, including behavioral health treatment; (6) prescription drugs; (7) rehabilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care.

The Essential Health Benefits Coalition (EHBC), whose membership includes the National Retail Federation, and the U.S. Chamber of Commerce, and America's Health Insurance Plans, are urging HHS to not adopt such a broad and all-inclusive definition of ESBs.  The EHBC has concluded that these benchmark options are misguided, not based on strong medical evidence and would keep coverage unaffordable and out of reach for many small employers and individuals.  (See the December 31, 2012 Letter from Neil Trautwein, Chairman, Essential Health Benefits Coalition, Vice President, Employee Benefits Policy Counsel National Retail Federation U.S. Department of Health and Human Services.) The EHBC is therefore urging the HHS to consider an approach that balances reasonably comprehensive benefits with affordability for employers and individuals.  Otherwise, the Essential Health Benefits as presently defined would make health coverage more expensive for employers and individuals to purchase and make jobs more difficult for employers to create.  In other words, EHBC is urging HHS the Affordable Health Care Act of 2010 to at least consider one of its primary mandates – the affordability of health care. 

About the Author: Margy Wenham has been working as an independent insurance agent for over twenty (20) years in Redding, California. She represents most major insurance carriers and can be reached by calling 530.221.0955, emailing her at MargyWenhamInsurance@gmail.com or by going to her website located at www.MedicareSupplementByMargy.com.

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