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
The Washington State Health Care Authority (HCA) submitted comments to HHS on essential health benefits, which are centered around four key questions. The comments are attached here. Also attached is a preliminary analysis, conducted by Milliman, of the state's health care benefit plans.