Milestone: Compare current state benefit mandates with the essential health benefit package and identify any needed changes
States will need to analyze how their benefit mandates compare with federal minimum requirements established by the ACA and decide whether to continue, add to or eliminate any state-mandated benefits.
*Milestone details:
*Full name: Compare current state benefit mandates with federal laws, regulations, and the essential health benefit packages and identify any needed updates.
*Relevance to the ACA:
The ACA establishes federal benefit mandates that all states must follow. The ACA also permits states to establish their own benefit mandates.
§1302 – Establishes the essential benefit package levels that define qualified health plans.
§1311 – Allows states to add additional benefit requirements to qualified health plans; costs would be borne by states rather than the federal government.
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District of Columbia
During the NASHP conference in October, Jeanene Smith of the Office for Oregon Health Policy and Research presented on Oregon's value-based benefit design efforts. Smith also highlighted how the state developed its prioritized list for health benefits.
District of Columbia
This presentation to the Oregon Health Policy Board on April 13, 2010 outlines key decisions the board will have to make in order to align its own activities with the ACA. Access it here: http://www.statereforum.org/sites/default/files/or_axn_plan_12.10.pdf