Republicans say administration's approach to health law benefits leaves taxpayers in the dark

Republican lawmakers on Friday accused the Obama administration of hiding the healthcare reform law's cost by failing to spell out the benefits that health plans must cover.

Last month, the Department of Health and Human Services released a bulletin that gives states flexibility when deciding what health plans will have to cover in order to gain access to federally subsidized health exchanges. House and Senate Republicans assailed that approach in identical letters to Health and Human Services Secretary Sebelius sent Friday.

"By issuing a 'bulletin' rather than a proposed rule," the letter says, "the Administration has sidestepped the requirement to publish a cost benefit analysis estimating the impact these mandates will have on health insurance premiums and the increased costs to the federal government.

"Additionally, the Administration has avoided publishing a list of unfunded mandates on states and the private sector by issuing a 'bulletin' rather than a proposed rule, and has also avoided publishing a list of regulatory alternatives."

The administration says it intends to issue regulations in the future in addition to the bulletin. Regulators have also requested public input on the issue, due Jan. 31.

Republicans did not immediately respond to a request for evidence that states have complained about the flexibility offered by the administration.

Some states have praised the administration's approach.

"It's a good start in the right direction," Utah Gov. Gary Herbert, a Republican, said last month. "Long before the new federal health care bill passed, our Exchange was built around the needs of consumers and small business, with minimal government involvement and expense.

"We've worked for many months to make sure the federal government would not smother our exchange, but we've been at an impasse. However, this new flexibility allows Utah's Exchange to continue in its current market-based design."

A Republican staffer said that while states need more clarity, the main motivating factor behind the letter was to seek more information on the benefits' cost to the federal government and taxpayers.

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