New job benefits package

WASHINGTON--  The Obama administration is rolling out a health benefits framework for millions of Americans who will get private insurance through the health care overhaul  and states get to decide the specifics.


Its tricky territory for the feds, who dont want to be labeled Big Brother on health care.


The framework proposed Friday allows states to pick from several federally approved options, ranging from packages offered to government employees to an HMO.


Starting in 2014, millions of people currently uninsured can buy private coverage in new state markets, with federal subsidies to help with premiums. Insurers must offer at least the basic benefits package.


The proposal we're putting forward today reflects our commitment to giving states the flexibility they need," Sebelius said. It's a prickly relationship, with 26 states asking the Supreme Court to toss out the law.
If a state doesn't want to pick benefits, the default will be the package available through the largest small business plan in that state.
Initial state reaction was positive. "Quite frankly, this was a very smart approach for HHS," said Kansas Insurance Commissioner Sandy Praeger. "It builds on existing state law." Praeger, a Republican, chairs the health care committee of the National Association of Insurance Commissioners.
Starting in 2014, millions of people now uninsured will be able to buy private coverage in new state markets; taxpayer subsidies would help with premiums.
Insurers wanting to participate in the new state health insurance exchanges will have to offer at least the federally approved "essential benefits package."
Business groups and consumer advocates are watching closely because they expect the federal government's decisions to set new national standards for health insurance. At issue is the right balance between affordable coverage and comprehensive benefits.
Under the law, the benefits package must include such fundamentals as inpatient and outpatient care, emergency services, maternity and childhood care, prescription drugs, preventive screenings and labs.
It must also cover mental health and substance abuse treatment, as well as rehabilitation for physical and cognitive disorders, and dental and vision care for children. Such additional benefits are often not fully covered by frugal plans that are now the best that many small businesses can afford.
Traditionally regulated by the states, private insurance benefits vary widely across the country. Large companies can opt out of most state rules, although they usually offer comprehensive coverage.
Consumer advocates had hoped Obama would set a robust standard for the whole nation. But his administration only met them part way.
"The essential health benefits package will for the first time define a minimum standard for health insurance coverage," said Stephen Finan of the American Cancer Society Cancer Action Network. "We urge states to choose a benchmark plan that provides the best care for someone at risk of a life-threatening chronic disease such as cancer.