Obama administration avoids political backlash by allowing states flexibility on essential benefits

Dec 20 2011

By allowing states the flexibility to make key decisions, the administration avoided a "political hot potato" regarding essential benefits -; the medical benefits insurers must cover under the U.S. health care.

Bloomberg: Obama Health-Insurance Decision Passes Political 'Hot Potato' To States
The Obama administration avoided a potentially brutal lobbying battle over the medical benefits insurers must cover under the U.S. health care overhaul when it decided last week to hand the decision off to states. ... Business groups will argue for a narrow set of benefits to save costs while consumer advocates push for expanded coverage. The decision shifts the debate to statehouses and away from the White House, and lets President Barack Obama say he's giving governors and legislatures more flexibility within their own communities to confront rising medical costs and control changes the 2010 health care law is bringing to insurance markets (Wayne, 12/19).

Politico: First Crack At Essential Benefits Dodges Backlash
The Obama administration's first crack at defining minimum health benefits did exactly what consumer groups hoped it wouldn't do: It gave states a choice of "benchmark" plans rather than spelling out the details. But the administration seems to have pulled it off -; because there was no backlash to be found from groups that championed the law (Millman, 12/18).

Denver Post: States Get Flexibility To Design Benefits Under Health Care Reform
A large Colorado consumer group said states will now have to resist insurer and anti-reform influence, and work hard to set high standards for patients. "In this guidance, HHS has effectively ducked their responsibility to make critical decisions," said Dede de Percin of the Colorado Consumer Health Initiative. "This approach potentially encourages and exacerbates a coverage race to the bottom among states" (Booth, 12/17).

Kaiser Health News: HHS Gives States Flexibility On Health Law's 'Essential Benefits'
States will be given wide latitude to decide what 'essential benefits' insurers must offer in their health policies come 2014, the Obama administration said Friday in a move that pushes off final federal rules on the topic until an unspecified date (Appleby, 12/16).

The Hill: HHS Defers To States, Will Let Them Decide Which Benefits Health Plans Must Cover
The Obama administration said Friday that it will defer to the states on one of the most important mandates in the health care reform law. The Health and Human Services Department said states will take the lead in determining the benefits that every health plan will soon have to cover. Defining "essential health benefits" is among the most important steps in implementing the Affordable Care Act. The law lists 10 broad categories of benefits that every plan sold to individuals and small businesses will have to cover, beginning in 2014. It leaves the specifics of that mandate to HHS. And HHS said it intends to pass the job down to states (Baker, 12/16).

Reuters: States To Weigh In On Basic Health Coverage
U.S. health officials will allow states to select the basic set of medical benefits that must be offered by insurance plans participating in new exchanges mandated by the federal healthcare overhaul, the U.S. government said on Friday. The Department of Health and Human Services announcement relates to the so-called essential health benefits for millions of Americans expected to qualify for coverage sold through state-based insurance exchanges beginning in 2014 (Krauskopf, 12/16).

The Associated Press: States Get Say On Health Benefits In Obama's Law
The Obama administration Friday rolled out a benefits framework for millions of people who will get private insurance through the health care overhaul, but states will decide the specifics. Under the new law, the federal government must set a basic benefits package for private insurance. That's tricky territory for the administration, which is trying to avoid the "big brother" label on health care. Obama will be defending his signature domestic law on two fronts near year -; before the Supreme Court and the voters (Alonso-Zaldivar, 12/16).

NPR: States Would Get More Flexibility On 'Essential Benefits' Under Proposal
It may or may not be a punt, but the Obama administration wants to let states play a bigger role in deciding what constitutes an "essential health benefits" package when it comes to health insurance. The Department of Health and Human Services issued what it called a "bulletin" outlining a policy it hopes to impose. In other words, it's not even yet a formal regulation. The idea is to give states "more flexibility and freedom" to implement the part of the health law that includes the essential health benefits requirement. Under the proposal, rather than having the federal government set a package of benefits for plans sold to individuals and small businesses, states could match the benefits of specified plans currently available to their residents (Rovner, 12/16).

Minnesota Public Radio: Health Coverage Required Minimum To Be Set By States
The Department of Health and Human Services will set a basic framework for what insurers must cover, but states will fill in the details. There is wide variation in the treatments and procedures that states require insurers to cover. A statement from State Commerce Commissioner Mike Rothman said the move "will provide Minnesota flexibility to ensure health plans sold in Minnesota meet the unique demands of Minnesota's consumers, economy, and health care system" (Stawicki, 12/17).