The Essential Health Benefits Coalition has backed recommendations made by the Institute of Medicine to the Department of Health and Human Services' on an essential health benefits package.
"The rising cost of health care is the most significant barrier to individuals obtaining and employers providing health coverage today," says Neil Trautwein, vice president of employee benefits for the National Retail Federation and chairman of the Essential Health Benefits Coalition. "We urge HHS to follow the IOM's advice. HHS should develop an essential benefits package that is affordable, solid but flexible, and is evidence-based."
Health care costs have risen sharply during the past decade. According to the Kaiser Family Foundation, average annual health insurance premiums more than doubled from $4,819 to $10,944 for employers and from $1,619 to $4,129 for workers since the year 2000. Every new benefit mandate comes at a cost. According to the Centers for Medicare and Medicaid Services, the growth in premiums from 2000-2010 tracked directly with the growth in required benefits.
In addition to keeping affordability a top concern, the coalition says HHS should also follow the IOM's recommendations for the treatment of state benefit mandates and the basis for making updates to the package. This includes:
- Ensuring state benefit mandates do not receive any special treatment and are subject to the same evaluative methods as all other elements of the package.
- Ensuring the model for updating essential benefits is based on sound evidence regarding the effectiveness of treatments and services and their cost.
"The IOM has made thoughtful recommendations that acknowledge that the essential health benefits package must strike a careful balance between affordability and comprehensiveness of coverage," says Trautwein.
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