Health reform implementation

Study: ObamaCare benefit mandates pose few problems for states, insurers

{mosads}But insurers and regulators in a sample of states were generally able to apply the new mandates easily, according to the new study.

“Overall the states in our review are managing the shift to essential health benefits well,” said Andy Hyman of the Robert Wood Johnson Foundation. “In these states, health plans offered through exchanges will offer coverage options that are comprehensive and high-quality, and will be offered at an affordable price.”

The researchers interviewed regulators and insurance industry officials in five states — two with federally run exchanges and three that are establishing their own marketplaces.

Regulators in Virginia said the shift to essential benefits would be significant because plans in the state often do not cover prescription drugs or maternity care. In the other four states, though, they said adopting the new standards wasn’t a big deal.

“In spite of initial concerns from some observers that the adoption of a new benefit standard would result in dramatic changes to insurance policies— and commensurate increases in cost — regulators in most study states reported that it did not result in a major market change,” the study said.

The healthcare law spells out 10 broad categories of essential benefits, but the Obama administration mostly left it up to states to fill in the specifics of how insurers would cover essential benefits. 

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