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Please Support a National Standard for Essential Health Benefits  

 Comment Deadline 1/31/12 

January 17, 2012 -- In a December bulletin, the U.S. Department of Health and Human Services (HHS) proposed to give states wide discretion to set their own essential health benefits (EHB) standard for health plans sold through the new exchanges. Not having a a clear-cut, comprehensive federal standard will likely result in significant disparities in coverage across states. Please send comments to [email protected] (through January 31, 2012).


Urge HHS to:

  • Create a national standard for essential health benefits instead of providing such wide flexibility to the states. By failing to adopt clear regulations, the ACA cannot be implemented in a way that fulfills its intent -- that coverage be sufficiently comprehensive to meet the needs of people with mild, moderate and severe mental illnesses and substance-use disorders.
  • Clearly define, at a minimum, the mental health and substance abuse benefit, including the requirement for parity with other medical/surgical benefits. This standard-setting is not only important to consumers but is key to ensuring stability and fairness in the insurance market.
  • Make specific provision for coverage of at least some of the psychiatric rehabilitation home and community-based services that are required for children and adults with more severe conditions. Without such provision, a high burden will fall on the state and local public mental health systems that are already overwhelmed. 

For "The Details" on the HHS proposal and our analysis, please see the full Action Alert here... 


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