Although the Sept. 30 deadline has come and gone for states to select the essential health benefits (EHB) insurers must include in plans sold through health insurance exchanges, less than half of states have made their decisions.
So far, 20 states--Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Kansas, Maryland, Michigan, North Dakota, New Hampshire, Nevada, New York, Oregon, Rhode Island, Utah, Virginia, Vermont and Washington--and the District of Columbia have submitted their EHB plans to the U.S. Department of Health & Human Services.
Small employer plans are the most popular benchmark with 15 states choosing such a plan. Three states--Connecticut, Michigan and North Dakota--chose an HMO plan, and Utah and Maryland selected a state employee plan, according to a Health Affairs blog post.
If states fail to determine their own EHB baselines--and some Republican governors are declining to show their reform law opposition--HHS will select a benchmark. For example, Alabama, Indiana, Pennsylvania and West Virginia all said they wouldn't choose an EHB benchmark because HHS hasn't provided adequate and clear guidelines.
Alabama Gov. Robert Bentley said in a letter to HHS Secretary Kathleen Sebelius that "there is simply not enough valid information available now to make an informed choice for such an important decision," reported LifeHealthPro.
Indiana, meanwhile, decided to delay its EHB decision until a new governor is elected and HHS offers more detailed guidance which, according to Insurance Commissioner Stephen Robertson, has been minimal and conflicting, reported the Northwest Indiana Times.