The healthcare law sets out 10 categories of essential benefits that all plans must cover, but left the details to HHS. And HHS said it would punt the job to states, a move that surprised just about everyone.
Sebelius said other, federally run parts of the law will act as a check on insurers, including a provision that requires them to spend 80 percent of their premiums on healthcare costs.
But, Stewart said, “if they can’t do that, and don’t want to, they get a waiver.”
HHS has agreed to modify the 80 percent threshold in a handful of states, though it has rejected most states’ requests.
“By and large, we have said no,” Sebelius responded.