Several national outlets reported that HHS released final rules on Wednesday for the ACA’s essential health benefits provision. Most note that the regulations, while integral to the law, have changed little since first proposed last November.
The New York Times (2/21, A16, Pear, Subscription Publication) reports, “The Obama administration issued a final rule on Wednesday defining ‘essential health benefits’ that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.” The rule “requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.” HHS Secretary Kathleen Sebelius “said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.”
USA Today (2/21, Kennedy) reports, “The Department of Health and Human Services released its long-awaited final rule on essential health benefits today, allowing insurers and states to move forward on both the federal and state health exchanges.” In a report accompanying the report, HHS wrote, “Americans accessing coverage through non-grandfathered plans in the individual and small group markets will now be able to count on mental health and substance use disorder coverage that is comparable to their general medical and surgical coverage.”
The Wall Street Journal (2/21, A2, Dooren, Subscription Publication) reports that the Obama Administration finalized rules Wednesday which mandate that health insurance plans cover mental-health and substance-abuse treatments, among other categories, starting next year under the Affordable Care Act. The rules fall under the provision of the ACA which requires essential health benefits in 10 categories of care, like prescription medications and physical rehabilitation. Specifics requirements for insurers will be set by the states.
Reuters (2/21, Morgan) reports that in the rule, HHS said, “The states continue to maintain their traditional role in defining the scope of insurance benefits and may exercise that authority by selecting a plan that reflects the benefit priorities of that state.”
The Hill (2/21, Goad) “Regwatch” blog reports that following the rule release, HHS Secretary Kathleen Sebelius said in a statement, “People all across the country will soon find it easier to compare and enroll in health plans with better coverage, greater quality and new benefits.”
The Washington Post (2/21, Kliff) “Wonkblog” notes that “the final regulation looks similar to a draft published in November. It still allows states to pick between a handful of benchmark plans, so long as they cover a core set of physical and mental health benefits.”
The NPR (2/21, Appleby) “Shots” blog reports further, “Essential benefit requirements apply mainly to individual and small group plans. The requirements also apply to benefits provided to those newly eligible for Medicaid coverage.”
Modern Healthcare (2/21, Zigmond, Subscription Publication) reports, “The final rule maps out standards for the core set of benefits that health insurance issuers must cover in the individual and small group markets-both inside and outside of the health insurance exchanges-for 2014 and 2015.” And, NBC News (2/21, Fox) reports, “The final rules harden up draft rules published last November, after taking into account thousands of comments.” The New York Business Journal (2/21, Hoover) and MedPage Today (2/21, Pittman) also cover the story.
— “New Federal Rule Requires Insurers to Offer Mental Health Coverage,”Robert Pear, The new York Times, February 20, 2013.