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Implementing the Affordable Care Act: Choosing an Essential Health Benefits Benchmark Plan

Overview

To improve the adequacy of private health insurance, the Affordable Care Act requires insurers to cover a minimum set of medical benefits, known as "essential health benefits." In implementing this requirement, states were asked to select a "benchmark plan" to serve as a reference point. This issue brief examines state action to select an essential health benefits benchmark plan and finds that 24 states and the District of Columbia selected a plan. All but five states will have a small-group plan as their benchmark. Each state, whether or not it made a benchmark selection, will have a set of essential health benefits that reflects local, employer-based health insurance coverage currently sold in the state. States adopted a variety of approaches to selecting a benchmark, including intergovernmental collaboration, stakeholder engagement, and research on benchmark options.

Publication Details

Publication Date: March 12, 2013
Summary Writer: Deborah Lorber
Citation:

S. Corlette, K. W. Lucia, M. Levin,  Implementing the Affordable Care Act: Choosing an Essential Health Benefits Benchmark Plan, The Commonwealth Fund, March 2013.

Experts

Research Professor and Project Director, Center on Health Insurance Reforms, Health Policy Institute, McCourt School of Public Policy, Georgetown University
Research Professor, Center on Health Insurance Reforms, Health Policy Institute, McCourt School of Public Policy, Georgetown University