New Rules for State Selection of Benchmark Plans to Determine Essential Health Benefits

from Ntl FV:

In April, the Centers for Medicare and Medicaid Services (CMS) released the final 2019 "Notice of Benefit and Payment Parameters" (NBPP), which governs insurance offered in the individual and small group markets pursuant to the Affordable Care Act (ACA). The 2019 NBPP alters the way that states can establish their benchmark plans for 2020 and beyond, allowing states to establish less generous benefits packages. States that want to update their EHB benchmark for plans sold in 2020 must submit their selection to the Department of Health and Human Services (HHS) by July 2, 2018, and they must post a notice for public comment on a relevant state website.

 

State family leaders can provide input as their states choose their benchmark plan and thus determine the benefits required to be covered in their state. The National Health Law Program recently released a Step-by-Step Guide to Updating States' Essential Health Benefits Benchmark Plans, which can help family leaders inform the state about the needs of CYSHCN and their families. See also Overview of Changes to the Essential Health Benefits Standards in NBPP 2019 (National Health Law Program, 4/23/18) and the Center for Budget and Policy Priorities (CBPP) summary of relevant changes made by the NBPP and the new guidance expanding the hardship exemption from the requirement to have coverage or pay a penalty.