Defining the Essential Health Benefits Package, in Law360May 24, 2011
Lynn Shapiro Snyder, Clayton Nix, and Lesley Yeung cowrote an article titled "Defining the Essential Health Benefits Package."
Following is an excerpt:
In April, the U.S. Department of Labor released a survey report that is being used to satisfy a requirement in the Patient Protection and Affordable Care Act (ACA) that the secretary of labor "conduct a survey of employer-sponsored coverage" as a condition precedent to the development of the "essential health benefits package" by the secretary of the U.S. Department of Health and Human Services.
This DOL survey is the first step in the process laid out in the federal health reform law for establishing the minimum benefits package to be offered in the various health insurance exchanges for which subsidies and tax credits will be available. Under ACA, the secretary of HHS ultimately has the discretion to determine the essential health benefits package, which goes to the heart of federal health reform by providing an adequate level of health insurance coverage to the uninsured and under-insured. That discretion is limited by certain conditions and requirements set forth in ACA.