Thursday, September 13, 2012

Time Dwindling To Pick State Health Insurance Benchmark

By Jamey Dunn, Illinois Issues
There's a week left for comment as Illinois officials weigh choices that will determine the future of the health insurance market in Illinois in two years, if not sooner.

As part of the federal Affordable Care and Patient Protection Act, Gov. Pat Quinn’s Health Care Reform Implementation Council met Wednesday to work on picking a benchmark for benefits that insurance companies must offer to individuals and small businesses. The council will recommend one plan that will set the standard for benefits offered in 10 service categories, such as prescription drugs, maternity care and laboratory services known as essential health benefits.

The council can choose among several existing plans, such as the three largest state employee health plans or the three largest group plans in the state. Once it picks a model, other insurers must offer equal benefits. The State must pick a plan as is and cannot add on or subtract benefits. The new council-set standards will kick in in 2014 and last until 2016, when the federal government plans to reassess the required essential benefits. The Council's choice will set a floor for required benefits, but insurance companies can offer more generous plans.

The council is taking public comment and suggestions through September 19, and Quinn must make a recommendation to the federal government by September 30. If the state does not choose a benchmark plan, the feds will choose one for it. Information and online comment entry are here: http://www2.illinois.gov/gov/healthcarereform/Pages/default.aspx

Council members Wednesday said they hope to ensure that there are strong benefit levels for mental health and substance abuse treatment, two areas they say are often inadequately covered by insurance. “It truly signals that there is greater acceptance and understanding that the treatment of mental health disorders and substance abuse must be a priority,” said Lorrie Rickman Jones, director of the Department of Human Services' Division of Mental Health.

Larry Barry, president of the Illinois Life Insurance Council, warned that requiring plans to have overly generous benefits could make the insurance too pricey. “Now you’ve got a wonderful product, but it’s one that no one can afford,” he said.

You can read Jamey's full report at: http://illinoisissuesblog.blogspot.com/2012/09/state-council-considers-required.html

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