Advocates hope funding oversight won't shortchange healthcare benefits

“From the perspective of the Cancer Society, we think it is probably the most important regulation under the Affordable Care Act because it goes to the whole issue of whether, going forward, all Americans will have adequate care to treat a serious medical condition like cancer,” said Stephen Finan, the senior director of policy for the American Cancer Society Cancer Action Network. “If you could start with a clean slate, you could systematically figure out what information you would most like to know and need to do an essential benefits package and you could design a survey to get to to that as directly as possible — as opposed to using the existing data, which doesn't always fit or match up with the general contours of the [law].”

It's too late now, the advocates acknowledge.

While the law doesn't set a specific deadline for the determination of the benefits package, it logically has to be finalized well ahead of the state insurance exchanges going online. Working backwards, experts say the administration probably needs to have a proposal ready by early- to mid-2012 so that insurance plans and state regulators can be ready by 2014.


Federal officials, however, gave advocates a ray of hope last week when they announced they'll be releasing new survey data within the next few weeks. While the Department of Labor already prepares an annual survey of employer benefits every August, the department was able to scrounge up some funds to look deeper into the data it had already compiled.

The new study will include data on 12 additional benefits, The Hill reported Thursday:

• Emergency room visits
• Ambulance services
• Diabetes care management
• Kidney dialysis
• Physical therapy
• Durable medical equipment
• Prosthetics
• Maternity care
• Infertility treatment
• Sterilization
• Gynecological exams and services
• Organ and tissue transplantation

Bureau of Labor Statistics associate commissioner Bill Wiatrowski acknowledged that the information will share some of the same limitations as the data already on hand.

“We used the same plan documents — the ones for reference year 2009 — to extract the additional provisions,” Wiatrowski told The Hill. “So we did not have to do any additional collection from employers, but we had to do additional extraction of data from the documents.”

Still, advocates like Finan are hopeful the new information can help federal regulators make a better informed decision.

“It's a matter of mining the existing data they have as well as they can,” he said. "We don't know what the Department of Labor has developed to this point. So I'm not going to jump to judgment and say it's inadequate. It may be [adequate]."