Health News
- Essential-benefits Rule Expands Mental-health And Substance-abuse Coverage; Ky. Needs More Facilities To Treat Newly Eligible
The Department of Health and Human Services has defined the 10 "essential health benefits" insurance plans must provide, and it included benefits for mental health and treatment of substance-abuse disorders.. Nearly 20 percent of Americans don't...
- Anthem Ppo Plan Chosen As 'benchmark' For State's Kentucky Health Benefit Exchange
The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization (PPO) plan serve as the ?benchmark? plan for the Kentucky Health Benefit Exchange, as well as for plans offered outside the exchange. The statement issued...
- Essential Health Benefits In Illinois - What's Next?
In December 2011, the Department of Health and Human Services released long-awaited regulations on the Essential Health Benefits (EHB). A major piece of the Affordable Care Act, EHB will define the minimum level of coverage that must be offered in plans...
- Essential Health Benefits: What?s It Mean For People With Hiv?
On December 16, 2011, the U.S. Department of Health and Human Services (HHS) announced that states would decide what essential health benefits will be provided under health care reform. Although we had urged HHS to adopt a uniform, national benefits...
- Top Ten Health Care Reform Terms You Should Know (but Were Afraid To Ask...).
On March 23, 2011, we will be celebrating the one year anniversary of the Affordable Care Act (ACA). Although we at Health & Disability Advocates are in the thick of ACA implementation, we know that many Illinoisans still are confused about the law....
Health News
The Essential Health Benefits--Comments from Health and Disability Advocates
On December 16th 2011, the Department of Health and Human Services released a much-anticipated bulletin on the Essential Health Benefits (EHB) package. Instead of containing information on what the package would contain, the bulletin deferred the task of defining EHB to each state. Supplementary information designed to clarify the approach taken in the bulletin was released on January 25, 2012.
Health & Disability Advocates, the organization which powers Illinois Health Matters, submitted their comments on these bulletins to HHS on January 31, 2012, reflecting specific concerns:
The role of the EHB package was to create a standard of health care covered by insurers for all Americans purchasing insurance through the state exchanges. This would mean a standard of adequate care for all, without discrimination due to age, gender, disability, chronic illness or geographical location. It is the vehicle that would bring the goal of health care reform, that is, high-quality, comprehensive care, to many citizens.
The proposed plan gives states a vague benchmark system, with no federal oversight currently put in place, to use in defining the EHB. Although it is understandable for states to want flexibility in defining their EHB package, the degree of flexibility HHs is allowing could permit states the freedom to eliminate important benefits or the protection the EHB provides against insurance discrimination. Furthermore, to hand off all of the important decisions regarding the EHB package to the states goes against Congress?s intentions in the ACA of a federal standard, defined by HHS, for minimum coverage. As HDA states in their comments, ?Simply said, the HHS EHB Bulletin is inadequate at best, and at worst, is an impediment to effective implementation? of health care reform.
HDA urges HHS to protect the potential of EHB plans by establishing an official, federal oversight process that involves a diverse range of perspectives, including those of people with disabilities and chronic illness. The HDA comments outline specific suggestions for the development of an EHB plan going forward that would safeguard the potential benefit of the EHB package, including the following:
- Reflects an appropriate balance among the categories describes in such subsection, so that benefits are not unduly weighted toward any category
- Does not make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life.
- Takes into account the health care needs of diverse segments of the population, including women, children, persons with disabilities, and other groups
- Ensures that health benefits established as essential are not subject to denial to individuals on the basis of the individuals? age or expected length of life or of the individuals? present or predicted disability, degree or medical dependency, or quality of life.
To read the full list of HDA?s specific concerns, read the full comments here.
Barbara A. Otto
Chief Executive Officer
Health & Disability Advocates
- Essential-benefits Rule Expands Mental-health And Substance-abuse Coverage; Ky. Needs More Facilities To Treat Newly Eligible
The Department of Health and Human Services has defined the 10 "essential health benefits" insurance plans must provide, and it included benefits for mental health and treatment of substance-abuse disorders.. Nearly 20 percent of Americans don't...
- Anthem Ppo Plan Chosen As 'benchmark' For State's Kentucky Health Benefit Exchange
The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization (PPO) plan serve as the ?benchmark? plan for the Kentucky Health Benefit Exchange, as well as for plans offered outside the exchange. The statement issued...
- Essential Health Benefits In Illinois - What's Next?
In December 2011, the Department of Health and Human Services released long-awaited regulations on the Essential Health Benefits (EHB). A major piece of the Affordable Care Act, EHB will define the minimum level of coverage that must be offered in plans...
- Essential Health Benefits: What?s It Mean For People With Hiv?
On December 16, 2011, the U.S. Department of Health and Human Services (HHS) announced that states would decide what essential health benefits will be provided under health care reform. Although we had urged HHS to adopt a uniform, national benefits...
- Top Ten Health Care Reform Terms You Should Know (but Were Afraid To Ask...).
On March 23, 2011, we will be celebrating the one year anniversary of the Affordable Care Act (ACA). Although we at Health & Disability Advocates are in the thick of ACA implementation, we know that many Illinoisans still are confused about the law....