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HHS releases FAQs on EHB

Posted on February 17, 2012 | No Comments

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Implementation Briefs
Key Developments

On December 16, 2011, the Department of Health and Human Services (HHS) released a Bulletin describing the approach it intends to take in future rulemaking to define the essential health benefits (EHB) under the Affordable Care Act. This document of frequently asked questions (FAQs) is intended to provide additional guidance on HHS’s intended approach to defining EHB. This bulletin describes a comprehensive, affordable and flexible proposal and informs the public about the approach that HHS intends to pursue in rulemaking to define EHB.  HHS intends to propose that EHB are defined using a benchmark approach. Under the department’s intended approach, states would have the flexibility to select a benchmark plan that reflects the scope of services offered by a “typical employer plan.” This approach would give states the flexibility to select a plan that would best meet the needs of their citizens.

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A report recently published by Georgetown University's Health Policy Institute, funded by the Robert Wood Johnson Foundation (RWJF), describes how states and health insurers are adopting the Affordable Care Act's (ACA) essential health benefits (EHB) requirements. Pursuant to the ACA, insurers offering plans in the individual and small group health insurance Marketplaces are required to offer benefits within the 10 specified EHB categories. RWJF found that for most Americans, benefit coverage will not drastically change. If anything, most individuals will now have access to services previously not covered by insurance, such as maternity health, mental health, and prescription drugs.
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