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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

AAMC Comments on Essential Health Benefits Bulletin

February 3, 2012—The AAMC Jan. 25 submitted comments  on the Essential Health Benefits (EHB) Bulletin published by the Center for Consumer Information and Insurance Oversight (CCIIO) on Dec. 16, 2011 [see Washington Highlights, Dec. 22, 2011].

The AAMC’s comments focus on three main areas.  First, the AAMC believes the federal government should take a more active approach in establishing a uniform EHB package to be used nationwide.  Furthermore, the AAMC has concerns about the lack of transparency of the benchmark plan selection process, as well as lack of public comment regarding the plan selection, benefit design, or changes made to the benchmark plans.  Lastly, allowing wide variability by states among the EHB covered in Exchange qualified health plans (QHPs) places administrative burdens on regional providers, such as academic medical centers (AMCs).

The bulletin lays out CCIIO’s intended regulatory approach for defining EHB, the core package of benefits that must be covered by QHPs offered through health insurance exchanges: utilize a reference plan or “benchmark plan” based on employer-sponsored coverage in the marketplace today, supplemented to ensure plans cover the 10 statutorily required categories in section 1302(b)(1) of the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152).  

Contact:

Jane Eilbacher
Policy and Regulatory Specialist
Telephone: 202-828-0896
Email: jeilbacher@aamc.org

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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org