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The Essential Work of Defining Essential Healthcare Benefits

Margaret Dick Tocknell, for HealthLeaders Media, October 5, 2011

And Robert Zirkelbach, press secretary for America's Health Insurance Plans, the trade association for the health insurance industry, says his organization would like to see coverage remain affordable, and that “when you add benefits, the health insurance will cost more.” AHIP also recommends that any definition of essential benefits embrace the federal employee’s health plan model, which provides a variety of cost-sharing levels so consumers can pay for what they want.

The IOM report will help (I hope) define and narrow some of the broad issues that must be considered. When the report is released, the IOM’s work will be done but the debate will just be starting.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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1 comments on "The Essential Work of Defining Essential Healthcare Benefits"


Matthew Bassett (10/7/2011 at 4:37 PM)
You were spot on when pointing out that the devil is in the details. The White House will carefully watch the response to the IOM report which will likely not satisfy anyone and only raise politically difficult questions. HHS is already saying that the final rule will not be out until May of next year at the earliest. This would be in the heat of the Presidential election and right around when the Supreme Court could rule on the constitutionality of the ACA. No one should be surprised if this is not settled definitely until after the election. At least this means that providers have time to express their views to state and federal officials. Payors' views are already well established and it seems the provider community is very late to the game. Providers need to make their voices heard now to help shape this important rule. Matthew Bassett, Revive PR