By Joe Touschner
While HHS outlined its approach for setting Essential Health Benefits in a Bulletin nearly a year ago, we’ve been waiting for federal regulations to make things official. This week, those regulations were proposed. The Department has posted info on the regs at these links:
EHB Proposed Rule
We’re still sifting through the documents, but it seems that the rule largely adopts the approach HHS outlined last December. One key change is that states will have the authority to define the EHB habilitation benefit if the chosen benchmark plan does not cover habilitative services. And it clarifies that states, if they choose, may limit insurers’ ability to substitute benefits within EHB categories.
Also on our reading list is a new proposed regulation on insurance market rules. This one will help define how some of the ACA’s private market reforms will work—reforms like guaranteed issue and the protection against charging more for those with health conditions. For kids, one important provision sets how health plans may set premiums based on age. Click below to find out more on this one:
Market Reforms Rule
These rules are the most recent in the series of regulations to help define how the ACA will be implemented. Check the CHIRblog for a great post looking ahead to others that should be coming soon.
