Kaiser Permanente Skeptical of CMS Proposal on State Health Benefits

CMS released a proposed notice to allow states to define the essential health benefits that health insurers in a state must offer. The notice suggested letting states either adopt another state’s 2017 benchmark plan or completely build a new essential benefits package so long as the new plan is not more generous than the current plan and is in line with a “typical employer plan.” Many major health insurers have expressed concerns that expanding required benefits would drive up costs. Kaiser Permanente is especially concerned with using a “typical employer plan” as a yardstick for essential health benefits, as self-funded employer plans are usually classified as atypical and are often customized to fit a specific population, making it hard to use as a judge of the status quo.