Essential Health Benefits Sign-on Letter

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Dear NVHR member:

Reports are that the essential health benefits package rules may already be at the Office of Management and Budget(OMB) and may be issued as guidance rather than regulations. Additionally - states will have significant flexibility in determining the benchmark for their EHB package (see clip below).

The HIV and viral hepatitis communities are circulating the attached letter to send to Secretary Sebelius and OMB calling for a robust national standard for people with HIV and viral hepatitis to reduce health disparities among these populations and improve our nation’s public health.

To sign on – please email Ryan Clary at by noon on Wednesday (12/14). Apologies for the quick turnaround.

From InsideHealthPolicy:

Essential Health Benefits

Several sources confirmed last week to IHP's Rachana Dixit that the Office of Management and Budget had received paperwork on the health law's Essential Health Benefits package. The OMB hasn't posted information yet, leading many to believe that the paperwork is likely guidance rather than a proposed rule – which it would be required to post.

Meanwhile, as Dixit notes, business and insurance groups have been urging HHS in private discussions to craft an essential health benefits package that is not only affordable but also flexible in nature and are anxiously awaiting to see how specific the EHB regulation or guidance will be in terms of benefits and cost-sharing. Industry sources say they were encouraged by several of the recommendations in the highly anticipated Institute of Medicine report on essential health benefits, including that the initial EHB package should be guided by a national average premium target and it should be linked to the actuarial value of a typical small employer plan. Yet industry officials remain concerned that the rule will not provide the flexibility they seek, worrying that HHS may follow CMS' more rigid approach with Medicare benefits and that a recent decision with respect to preventive services coverage could serve as a signal for what direction the department will take with EHB, sources say.

Copy of sign-on letter is attached in PDF format.