Remember all that “essential health benefit” business in the Affordable Care Act (ACA)? You know, how insurance plans sold on he upcomimg state insurance exchanges will have to cover certain basic benefits in order to be qualified?
Well, the ACA said it was up to HHS to say what the essential health benefit package should include. HHS then enlisted the Institute of Medicine (IOM) to propose a set of criteria and process to help HHS figure out which benefits should be included, taking into consideration things like advances in science and costs and such.
Basically, the IOM committe was tasked with finding a way to make sure that health insurance not only guarantees people access to the health benefits they need, but that it is also affordable. Sounds like a tricky balance to strike, but a necessary one. The IOM committee was not charged with actually defining what the essential health benefits should actually be. That’s still up to HHS.
Yesterday, the IOM released their report to HHS. You can click here to read the report, titled “Essential Health Benefits: Balancing Coverage and Cost.”
Also, check out the IOM website to read the press release, an overview of the criteria identified, and other materials.