The essential health benefits (EHBs) countdown is on for 2016.
That’s when this provision of the Affordable Care Act, which sets out 10 specific health services that must be covered by plans sold on the exchanges, will likely be reviewed by the Department of Health and Human Services. Business interests and consumer advocates are already making their positions clear – the former pushing for greater consciousness of premium costs and the latter looking to safeguard consumers’ coverage.
During a July 21 Capitol Hill briefing, members of the Affordable Health Benefits Coalition, a business interest group including the U.S. Chamber of Commerce and the National Retail Federation, said they would push to reshape essential benefits, arguing that current regulations have led to unaffordable hikes in insurance premiums.
Current policy requires plans cover emergency services, pre- and post-natal care, hospital and doctors’ services, and prescription drugs, among other things. The rule lets states decide how specifically to interpret those categories.
“What I hope is that they tear down the existing EHB and rebuild it from the bottom up,” said Neil Trautwein, employee benefits policy counsel for the National Retail Federation, in an interview. Trautwein said the group would lobby both members of Congress and White House officials starting in 2015, in addition to making sure this issue is part of congressional candidate’s talking points in November’s midterm elections.
But consumer advocates will be working on a separate path in the months ahead.