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House Democrats fret over administration's deference to states on health law
The Obama administration risks giving insurers too much power to determine Americans' healthcare benefits if it turns that decision over to the states, House Democrats said Monday.
In a letter to Health and Human Services Secretary Kathleen Sebelius, the lawmakers raise concerns with the administration's decision to give states broad latitude when determining the so-called "essential health benefits" health plans will have to offer in order to be sold on subsidized health exchanges starting in 2014. They worry that the default benchmark plans could be too restrictive or vary greatly by state.
"As authors of the law," they wrote, "we established a defined set of benefits so that families would have access to meaningful coverage and to enable consumers to easily compare coverage options in a transparent and understandable manner — something totally missing in today's health insurance marketplace. Furthermore, requiring insurers to provide coverage for a defined set of benefits will protect against their ability to design benefit packages to attract certain populations and avoid others."
The lawmakers, however, are concerned that too much flexibility could provide "even further discretion to insurers."
In particular, they have "serious concerns" that allowing states to make substitutions within and across the 10 benefit categories outlined in the law would "undermine" the law's goals and provide "insurers with the tools they need to continue avoiding sicker individuals rather than competing on quality and efficiency."
The letter was signed by the top Democrats on the committees of jurisdiction over healthcare — Reps. Henry Waxman (Calif.), Sandy Levin (Mich.) and George Miller (Calif.) — and Reps. Frank Pallone (D-N.J.), Pete Stark (D-Calif.), Robert Andrews (D-N.J.) and John Dingell (D-Mich.).
