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
Pricewaterhouse Coopers has conducted a preliminary analysis on the impact of potential benchmark health benefit plans in Virginia, based on the essential health benefits bulletin issued by HHS. This analysis also examines the potential impact on premiums for each option. As states begin to assess their benchmark plan options, which will need to be selected by Q3 2012, this analysis may be helpful.