Employer-insurer coalition asks HHS to pare essential benefits

Published on January 25, 2013 at 12:28 AM · No Comments

Employers, insurers and health providers worry that requiring expansive coverage in the policies sold in health insurance markets could make insurance unaffordable.

Modern Healthcare: HHS Urged To Keep Essential Benefits Affordable For Small Business
A coalition of business groups, health plans and health care providers is urging HHS to follow private-sector approaches as the department develops a final rule on the essential health benefits that individual and small-group plans must cover as part of the 2010 health care reform law. The Essential Health Benefits Coalition, whose membership includes the National Retail Federation, the U.S. Chamber of Commerce, America's Health Insurance Plans, the American Osteopathic Association and the Pharmacy Care Management Association, submitted a list last month of six recommendations to HHS in response to the department's November proposed rule on essential health benefits (Zigmond, 1/23).

CQ Healthbeat: Employers, Insurers Press CMS To Prune Essential Benefits
The growing concern among insurance analysts that coverage will be unaffordable in the new health care exchanges might create a fresh opportunity for federal officials to be persuaded to trim requirements in the final essential health benefits rule, which is expected out in February or March. Employers and insurers certainly hope so. With a few weeks to go before the final version is expected, they held a news briefing Wednesday to highlight six recommendations for shaping the rule in a way that they say makes coverage less costly (Reichard, 1/23).

Premiums for smokers under the health law are also getting attention --

California Healthline: The Premium Conundrum: Do Smokers Get A Fair Break Under Obamacare?
The Affordable Care Act contains a number of provisions intended to incent "personal responsibility," or the notion that health care isn't just a right -- it's an obligation. None of these measures is more prominent than the law's individual mandate, designed to ensure that every American obtains health coverage or pays a fine for choosing to go uninsured. But one provision that's gotten much less attention -- until recently -- relates to smoking; specifically, the ACA allows payers to treat tobacco users very differently by opening the door to much higher premiums for this population. That measure has some health policy analysts cheering, suggesting that higher premiums are necessary to raise revenue for the law and (hopefully) deter smokers' bad habits. But other observers have warned that the ACA takes a heavy-handed stick to smokers who may be unhappily addicted to tobacco, rather than enticing them with a carrot to quit (Diamond, 1/23).

In the meantime, the GOP returns to efforts to repeal parts of the health law in a new Congress --

Modern Healthcare: New Session Of Congress Brings More Anti-Reform Legislation
New year, same resolution. Just weeks into the 113th Congress, GOP lawmakers are making attempts to dismantle the 2010 healthcare law, and one of those efforts has bipartisan support. That's the legislation introduced today by Rep. Phil Roe (R-Tenn.) to repeal the Patient Protection and Affordable Care Act's contentious -- and unpopular -- Independent Payment Advisory Board. Roe, a physician, introduced his bill in the last Congress and more than 230 co-sponsors signed onto it, including 20 Democrats (it later passed as part of other legislation). The bill Roe introduced today currently has 83 original co-sponsors from last year's legislation, and a spokeswoman for Roe said in an e-mail that his office expects the bill to gain support (Zigmond, 1/23).

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