If your state is like a many others, you’ve likely been hearing or participating in active discussions around setting the essential health benefits for your state. (Check out this State Refor(u)m chart for a list of state activities and documents related to EHBs.). Every state, whether it will have a state-run or federally facilitated exchange, has the responsibility to select the minimum benefits that will apply in 2014 in the individual and small group markets, for newly eligible Medicaid beneficiaries, and in any Basic Health plan. While we’re still waiting for rules to make it official, HHS has indicated that states should make this choice before the fourth quarter of this year. So the decision will be coming up quickly, but unless you’re in one of two states that have acted already, it probably hasn’t been made yet.
Kids’ advocates in several states have been engaged in the choice of EHBs and have recognized that there are a number of issues important for kids. We here at CCF have put together a guide that may be helpful in thinking through these issues and getting involved in your state’s choice. Take a look for an overview of the EHB selection process, our interpretation of the ACA’s requirement for coverage of pediatric services, and some recommendations for engaging in the process.