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 Legislative & Policy Corner

Health Reform Implementation
 
Proposed Essential Health Benefit Benchmark Plans
A set of essential health benefits (EHBs) are required of all plans sold on the Health Insurance Marketplace or all new non-grandfathered plans sold outside of the Health Insurance Marketplace. The 10 EHBs include:

  1. Ambulatory (outpatient) care
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care

 
The existing EHB benchmark plans for states are available here. States have submitted proposed EHB benchmark plans for 2017, available here. Public comment period on the proposed plans ends at 11:59 p.m. EDT on Sept. 30. The public comment period offers an opportunity for Title V programs to engage in the transformation of the health care delivery system. Most of the 10 EHB requirements are pertinent to MCH populations throughout the life course. Title V programs have the opportunity to review the proposals to better understand the types of benefits and scope or limitations on services, as they pertain to MCH populations.
 
ACA Funding to Help Consumers Sign-up for Insurance
Earlier this month, the Centers for Medicare and Medicaid Services (CMS) awarded $67 million in ACA funding to help consumers sign-up for affordable Health Insurance Marketplace coverage in 2016. Awarded to 100 organizations located in 34 states that operate Federally Facilitated Marketplaces and State Partnership Marketplaces, the three year-long Marketplace Navigator grants will fuel efforts to help consumers enroll in a health plan that fits their budget and best meets their family's needs. More information can be found here.
 
Medicaid Expansion
Alaska expanded their Medicaid program effective Sept. 1, 2015. It is estimated that expanding Medicaid will bring $146 million to the state in its first year and provide health care to more than 20,000 working Alaskans. More information on the program can be found here.