Essential Health Benefits: Balancing Affordability and Adequacy

Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets – will be required to cover a set of health benefits and services called the “essential health benefits” package. Guidance issued last month by the Department of Health and Human Services will give each state some discretion to specify benefits package raises many questions. What is the task before states in selecting and designing “benchmark” plans that are comprehensive but also affordable? How will states incorporate state benefit mandates? What recommendations did the Institute of Medicine make on ensuring that health plans are affordable over time? To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored a February 3 luncheon briefing.

For more information and access to the presentation slides, please visit the Alliance’s event page.

Speakers:

The panel was co-moderated by Ed Howard of the Alliance for Health Reform and Sara Collins of The Commonwealth Fund.

 

Panelists:

  • John Santa, Consumer Reports
  • Janet Trautwein, National Association for Health Underwriters
  • Chris Koller, Rhode Island health insurance commissioner
  • Kavita Patel, Brookings Institution

 

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