Government Healthcare Policy, Business and Technology

How states are defining essential health benefits

Modern Healthcare: Two states so far have taken advantage of the federal government's decision to give them more leeway in defining the essential health benefits that individual and small group insurers must offer consumers. Those states—Alabama and Illinois—diverged significantly in how they responded to that flexibility.

In April, the CMS finalized a rule that would allow states to determine the minimum essential health benefits that individual and small business health plans operating in the state are required to cover, beginning in 2020. While the agency said the extra flexibility would let insurers create plans more tailored to members' needs, policy experts warned the rule could lead to skimpier coverage if states chipped away at benefit requirements.

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