Debate over Mandates in “Essential Benefits Package” Continues

As the Institute of Medicine continues to struggle to complete the “Essential Benefits Package,” they are now calling on the Department of Health and Human Services (HHS) to seek public input. This week, the HSS began gathering feedback from a wide variety of coalitions and interest groups in order to establish the specific mandates that will be included in the mandatory coverage guidelines under federal healthcare law. Once established, private insurers will be required to follow all included mandates to gain access to federally subsidized insurance exchanges by 2014.

As stated by Dan Daly, executive director of the essential health benefits coalition, the Essential Benefits Package and all mandates within are being established “in order to ensure workers can get the health coverage they need,” but not all parties remain optimistic about the initiative. The debate over what should be included in the package is expected to remain heated throughout the upcoming years, putting interest groups at odds with each other as they each struggle to be heard and the question of what will become of current mandates from individual states remains.
Groups like the End Obesity Action Fund, the National Health Council (which advocates for people with chronic diseases and disabilities), and the Habilitations Benefits coalition have already begun to petition the HSS to include representative mandates. Orrin Hatch, a republican member of the senate finance committee’s subcommittee on health care urged HHS secretary Sebelius to “examine these mandates with care and to understand that these mandates are a lead weight around the necks of families and businesses at a time of economic uncertainty and high unemployment” in a recent statement.
While the HHS has stated that it believes flexibility and affordability should remain paramount, it remains unclear how either will be established. Last week, the IOM issued recommendations involving the methodology for establishing the specific mandates but has not yet issued any specifics. Many expect health insurance premiums to rise until all issues with the Essential Benefits Package are resolved.