Health Law Buzz Words: Essential Benefits, MLRatio And Federal Exchanges

Officials from the Department of Health and Human Services are seeking input from stakeholders regarding how to structure the health law's essential benefits package. Also, new documents detail the dynamics behind Florida's MLR waiver request. Meanwhile, HHS signals that there will be a federal exchange.

CQ HealthBeat: HHS Solicits Stakeholder Opinions On Essential Health Benefits
The Department of Health and Human Services Tuesday held a closed-door meeting involving dozens of provider groups airing their views on what should be included in an essential health benefits package. The stakeholders in attendance were told that meetings with consumer advocates and insurers are expected to follow soon, as HHS seeks input on how to structure benefits. The meeting, which was not open to the press and reportedly was organized just late last week, follows the release of recommendations on essential health benefits by the Institute of Medicine (Norman, 10/18).

Politico Pro: Documents: MLR Didn't Make Insurance Flee
When Florida asked for relief from the new medical loss ratio requirements earlier this year, it warned HHS of an exodus from the individual insurance market, citing four insurers who quickly dropped out of the market after health care reform passed. But those fears may have been overblown, according to new documents HHS posted about Florida's request for temporary MLR relief — because only one of those insurers actually blamed the health care reform law. At least four insurers abandoned Florida's individual market in the months following the passage of health care reform, prompting Florida Insurance Commissioner Kevin McCarty to seek relief from new medical loss ratio standards requiring the insurers to spend at least 80 percent of premium dollars on providing actual care (Millman, 10/18).

CQ HealthBeat: There Will Be A Federal Exchange, HHS Official Hill Declares
The HHS official in charge of overseeing the creation of insurance exchanges under the health care law emphasized Tuesday that a federal exchange will be ready to step in to the extent states don't have their own new marketplaces ready to offer insurance choices to the uninsured by Jan. 1, 2014. "There's been a lot of backing and forthing in the press saying the feds won't do it, it's not going to happen, we don't have the ability. Well, I'm here to tell you all of that isn't true," Tim Hill told a health care conference sponsored by the American Bar Association (ABA). Hill is deputy director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services (Reichard, 10/18).

And the latest legal developments regarding the health law —

Politico Pro: Justice Asks SCOTUS To Review Mandate
The Obama administration is asking the Supreme Court to examine whether the health care reform law's individual mandate is constitutional, and which pieces should be struck if it is not — but not to take up related questions about its Medicaid expansion and employer requirements. The Justice Department replied this week to two of the pending health reform-related petitions in front of the Supreme Court, more than 10 days ahead of schedule. Last month, the Justice Department asked the court to review the health care law for the first time. Now the administration and opponents of the law are filing opposing briefs to the court about which pieces of the law and which issues should be reviewed. The court has petitions in four health care reform cases that have been reviewed by lower courts (Haberkorn, 10/18).

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