This is hard to read, but bear with me. I think it's a big change to the essential health benefits rule.pic.twitter.com/SHpyFBVsI3
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This is hard to read, but bear with me. I think it's a big change to the essential health benefits rule.pic.twitter.com/SHpyFBVsI3
The ACA says EHBs must be "equal to the scope of benefits provided under a typical employer plan, as determined by the Secretary."
What counts as "typical" is really important. If typical is "whatever Blue Cross/Blue Shield covers," EHBs are pretty expansive.
But they'll be pretty narrow if a "typical" plan is defined as some two-bit plan that doesn't cover much.
Here, HHS is saying that any plan, in any state, that covers more than 5,000 people will count as typical.
That means a single outlier plan can now count as typical, even if it's way stingier than every other plan on the market.
In other words, HHS seems to read the word "typical" to mean "typical and atypical plans." That may not be legal.
It also makes me wonder if HHS has in mind some large employer with a super-narrow health plan. If so, voila, that plan is now "typical."
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