Coalition offers HHS recommendations for consideration on Essential Health Benefits

Coalition offers HHS recommendations for consideration on Essential Health Benefits

Essential Health Benefits CoalitionStacey Rampy, 202-585-0258

The Essential Health Benefits Coalition (EHBC) announced today its recommendations for the Department of Health and Human Services (HHS) to consider as it works to develop the essential health benefits package in the new health reform law.

The EHBC appreciates that HHS recognized the crucial need for state flexibility in its transitional strategy to implement the essential health benefits (EHB) package. Providing flexibility in selecting a benchmark plan will help assure that states can tailor benefits to meet their residents’ health needs. Of equal importance is the need to ensure availability of high-quality, affordable coverage options. Simply stated, making certain that EHB packages do not put the cost of coverage beyond the reach of small businesses, their employees and individuals must be a central objective.

“HHS has an opportunity to develop an essential health benefits package that is both affordable and flexible to ensure that workers can get the health coverage they need,” said Stacey Rampy, executive director of the coalition. “We look forward to working with Secretary Sebelius and hope these recommendations are helpful in reaching that crucial goal.”

As HHS continues its work in developing EHB policies, the Coalition offers the following for consideration:

The broad-based coalition – composed of groups representing employers, pharmacy benefit managers and health plans across America – has previously cautioned that an expansive essential health benefits package would force employers to: absorb higher health care costs at the expense of creating new jobs and increasing wages; pass more costs onto their workers; or stop offering health coverage altogether. For employers who do not currently offer coverage, an expansive essential benefits package would put affordable coverage further out of reach.

“The high cost of health care and coverage is the biggest barrier today to coverage for individuals and employers alike. The question of whether individuals and employers can afford to buy the essential health benefits package must be the crucial consideration. An expansive, costly essential health benefits package could cause many employers to drop coverage and force more Americans into government-subsidized health care at a significant cost to taxpayers,” said Neil Trautwein, vice president and employee benefits policy counsel at the National Retail Federation and chairman of the coalition. “In today’s fragile economy where job creation is a priority, neither employers, workers nor taxpayers can bear the burden of higher health care costs and reduced wages as a consequence.”

The Coalition has long maintained that there are four essential criteria that HHS’ final essential benefits package must satisfy:

The EHBC is a broad-based organization composed of trade associations representing large and small employers from various sectors of the U.S. economy, pharmacy benefit managers, and health plans operating in nearly every state. The growing membership of the coalition includes the National Retail Federation, U.S. Chamber of Commerce, National Federation of Independent Business, National Association of Manufacturers, National Association of Wholesaler-Distributors, National Association of Health Underwriters, Blue Cross and Blue Shield Association, Retail Industry Leaders Association, Prime Therapeutics, America’s Health Insurance Plans, Express Scripts Inc., American Osteopathic Association, National Association of Dental Plans, Delta Dental Plans, Council for Affordable Health Insurance, Communicating for Agriculture, The IHC Group and Pharmaceutical Care Management Association. To learn more please visit