Health law rule on ‘essential benefits’ sent to White House for final review

The White House has begun a final review of two major rules drafted to implement President Obama’s healthcare law.

Both of the rules, written by the Department of Health and Human Services (HHS), are considered significant, meaning they each carry an annual economic impact exceeding $100 million. 

The first would, among other provisions, create new standards for defining “essential health benefits” to be provided under the landmark law.


“This rule ensures that consumers can shop on the basis of issues that are important to them such as price, network physicians, and quality, and be confident that the plan they choose does not include unexpected coverage gaps, like hidden benefit exclusions,” according to a description of the rule on the White House’s regulatory website.

The rule, to take effect next January, also proposes a timeline for qualified health plans to be accredited in the health insurance exchanges that are being set up around the country.

The other rule moved to the White House for review involves parameters of programs designed to protect health insurers from financial losses.  Those losses, administration officials contend, would likely be passed along to patients.

“The purpose of these programs is to protect health insurance issuers from the negative effects of adverse selection and to protect consumers from increases in premiums due to uncertainty for issuers,” a description of that rule states.

It too would take effect in January of next year. Neither rule carries a specified price tag. HHS argues that healthcare benefits for millions of Americans would be delayed if they are not finalized on time.