Sebelius provides rational for essential benefits guidance

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HHS Secretary Kathleen Sebelius defends the approach they are taking with providing guidance on essential health benefits, stating in a USA Today column that the department’s approach will "protect consumers while giving plenty of freedom to states."

The essential benefits guidance is meant to provide balance between  providing specific details that most consumer groups want and the flexibility that states desire as they approach the challenge of addresses the conflicting pressures the department is under as it crafts rules for the benefits insurance plans will be required to cover. Consumer advocates wanted the department to lay out a detailed benefit package, while states want to make sure they have flexibility and choice to make decisions about their insurance market.

In the column posted on the USA Today website Tuesday, Sebelius wrote:

This approach will ensure that all plans offered in this marketplace are comprehensive, without the gaps in coverage that too many consumers have faced. ... For consumers, this means you won't have to read every line of the fine print to know that the plan you buy will protect you if you get sick …

But we also know that health care is different in every state, and that the coverage that works in Florida might not work in Nebraska. Under the approach we have outlined, states will have the flexibility to pick their own standard from among the most typical, popular and proven employer plans in their own state.


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