Benefits & Services
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New Guide to EHB from CCF
By Joe Touschner 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…
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Child Health Advocates’ Guide to Essential Health Benefits
By Joe Touschner This guide highlights considerations for the selection of the essential health benefits with a focus on services for children. The Department of Health and Human Services has determined that each state will select an essential health benefits package based on an existing employer-based health plan. The guide outlines the process for choosing and supplementing…
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Essential Health Benefits Resources List
The following is a resource list related essential health benefits.
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CCF Shares Resource List on Essential Health Benefits
By Joe Touschner If you’re a regular Say Ahhh! reader, you’ve seen a number of posts already on the ongoing process to define the essential health benefits. Most of those linked to additional supporting documents, like the Bulletin and FAQ released by HHS and the comparison of potential benchmark plans from Maine’s insurance department. And many more…
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CMS EHB FAQ
By Joe Touschner Despite that title, our blog is not converting to the abbreviated language of texts and Twitter–I promise to type out the words in full when they’re needed. We’re also definitely not moving with Twitter speed in bringing you the news, but on February 17, the Centers for Medicare and Medicaid Services released…
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What’s the Score? CBO’s Updated Baseline Released
By Martha Heberlein I don’t know what you did yesterday, but I spent the day eagerly awaiting CBO’s annual March baseline. As the “official scorekeepers” in Washington, their projections of spending and enrollment in Medicaid, CHIP, and coverage under the exchanges carry a lot of weight. Besides, who wouldn’t love the neat little tables they produce…
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Is Your State Reviewing Potential EHB Benchmarks?
By Joe Touschner HHS’s essential health benefits bulletin is less than two months old–in fact, the comment period just closed this week, click here for our comment letter–but some states are already planning for what it could mean for their residents. The Bulletin indicates that states will be able to choose the core of their…
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HHS Shares Info on Small Group Plans
By Joe Touschner It’s a busy month on the essential health benefits front! As we’ve noted, one option for states under the proposed approach for state-defined EHB packages is to use one of the state’s three largest small group plans as a benchmark. It’s been difficult to evaluate this proposal because we didn’t know which…
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Essential Health Benefits: What Does the CHIP Experience Show Us?
So my previous blog on this topic talked about how the CHIP/Essential Health Benefits analogy has its limits – still it is interesting to look at the choices that states have made for their benefits packages in separate state CHIP programs. According to data collected and released by NASHP from mid-2008, the most popular choice…
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NASHP and Children’s Dental Health Project Issue Report
By Leigha Basini, National Academy for State Health Policy The new year brings many new things: new discussions about CCIIO’s newly released Essential Health Benefits (EHB) Bulletin and benefit provisions in the seemingly still new Affordable Care Act. But state CHIP directors may also be thinking about a slightly older benefit provision–the CHIPRA dental mandate. NASHP,…
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Essential Health Benefits: A Child’s Perspective
As soon as rumors started flying about what would be in the essential health benefits guidelines I thought hmmmm that sounds a lot like CHIP. At first blush the new guidance does sound like the CHIP model – indeed the guidance says as much (p. 8). But as HHS officials and others have pointed out,…
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HHS Suggests States Will Have Choices on Essential Health Benefits
By Joe Touschner For nearly a year now, we’ve been tracking the process of defining the essential health benefits. The EHB package will define the minimum set of benefits to be covered by insurance plans in the individual and small group markets as well as benchmark Medicaid plans and Basic Health Programs. On Friday afternoon,…
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A Chance to Raise Your Voice for Kids
By Joe Touschner We’ve posted in the past about the essential health benefits–the package of benefits that will be the basis for all health plans in the individual and small group markets and for some in Medicaid starting in 2014. Last month, the Institute of Medicine made recommendations to the Department of Health and Human…
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IOM Report Starts Process of Defining Essential Health Benefits
By Joe Touschner The Affordable Care Act will bring health coverage within reach for millions of uninsured people. The law, though, doesn’t answer the question of exactly what that coverage will look like–that is, what benefits it will cover. The law charges the Secretary of the Department of Health and Human Services to define an…
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IOM Works to Define Process for Essential Health Benefits
By Joe Touschner Even as the House of Representatives takes time to re-debate the Affordable Care Act, many organizations are hard at work implementing the new law. Last week, an Institute of Medicine panel held a two day meeting to help develop recommendations on essential health benefits that will form the basis for state-based exchange…
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GAO Finds Medicaid & CHIP Dental Care Slowly Improving
By Meg Booth and Colin Reusch, Children’s Dental Health Project It’s been almost four years since the tragedy of Deamonte Driver, a twelve-year-old Maryland boy who died due to complications of an untreated abscessed tooth. His death highlighted the worst case scenario for families struggling to find dental care. Those of you who know Children’s…
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Insurance Commissioners Respond to Consumer Concerns
By now many of you have probably heard about the big news coming out of the NAIC meeting this week in Orlando. After seven months of intense debate and negotiation, the NAIC voted in favor of a regulation defining the ACA’s required “medical loss ratio” (MLR). They rejected several amendments that were heavily pushed by…
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Let’s Take a Break from Biting Our Nails on Health Reform to Think About Teeth
Mom: “Did you brush your teeth?” Child: “Yep.” Mom: “How come your toothbrush isn’t wet?” This is an excerpt from the script of the bedtime drama performed live nightly in the comfort of my own home. Just between you, me and the tooth fairy … after battling on the nutrition, hygiene and homework fronts, I…
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New CMS CHIPRA Guidance Coming – Straight from the Source
By Joe Touschner As we all follow the twists and turns of health care reform in Congress, it’s easy to forget that the critical children’s health legislation that’s already been passed this year–CHIPRA–is well on its way to being implemented. CMS Medicaid and State Operations Director Cindy Mann (CCF’s former fearless leader) took the time…
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Health Reform Bill’s Pediatric Dental Benefit Could Have A Tremendous Impact on Children’s Health
Meg Booth, Deputy Executive Director, Children’s Health Dental Project In the past months of health reform debate, we at Children’s Dental Health Project have continuously heard the surprise and elation that all of the House and Senate Committees debating this issue included a dental benefit for children as part of their proposals. The disappointment later…