Unbiased Analysis of Today's Healthcare Issues

States to Determine Essential Health Benefits

Written By: Jason Shafrin - Nov• 14•12

As part of the Health Reform (a.k.a. Obamacare, a.k.a. the Affordable Care Act), States have to create health insurance exchanges for the individual and small group market. Can any plan join the exchange? The answer is no. Plans in the exchange must cover, at a minimum, meet certain essential health benefits (EHB).

How do states determine what services qualify for the EHB? They you the coverage of existing health plans as a benchmark to create Essential Health Benefits Benchmark Plans.

How much progress have States made? Using data from Avalere Health, we can summarize the progress as follows:

Although one third of states have proposed an EHB Benchmark plan; another third have identified potential benchmark plans and another third have done nothing.

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