Under the 2010 Patient Protection and Affordable Care Act, the secretary of Health and Human Services (HHS) is required to develop a package of essential benefits that must be included in all plans sold through the new health insurance exchanges. On Dec. 16, 2011, HHS released a bulletin on the essential health benefits package. According to the bulletin, HHS intends to propose regulations that will require states adopt an essential health benefits package using one of four benchmark plans. (See the SHRM Online article, "HHS to Give States More Flexibility to Set 'Essential Health Benefits.'")
However, HHS sidestepped several important disclosure requirements under the health care reform law and is preventing Congress and the public from being able to assess the true costs associated with the law's essential health benefits mandate, according to a Jan. 13, 2012, letter sent to HHS Secretary Kathleen Sebelius from several House chairmen and Senate ranking members.
The letter was signed by Energy and Commerce Chairman Fred Upton, R-Mich., Ways and Means Chairman Dave Camp, R-Mich., and Education and the Workforce Chairman John Kline, R-Minn., and their counterparts in the Senate, Sen. Mike Enzi, R-Wyo., ranking member on the Senate Health, Education, Labor and Pensions (HELP) Committee, and Sen. Orrin Hatch, R-Utah, ranking member on the Senate Finance Committee.
“By issuing a ‘bulletin’ rather than a proposed rule, the administration has sidestepped the requirement to publish a cost-benefit analysis estimating the impact these mandates will have on health insurance premiums and the increased costs to the federal government,” the chairmen and ranking members wrote. “Additionally, the administration has avoided publishing a list of unfunded mandates on states and the private sector by issuing a ‘bulletin’ rather than a proposed rule and has also avoided publishing a list of regulatory alternatives. Finally, the administration is not required to respond to comments received regarding this ‘bulletin.’ Publishing a ‘bulletin' rather than a proposed rule is the antithesis of an ‘open and transparent’ process.”
The letter requested that HHS provide the following information by Jan. 27, 2012:
1. The legal basis and rationale for pursuing a “bulletin” rather than a proposed rule.
2. Information documenting the instances over the past 20 years when an agency pursued this type of action prior to publishing a proposed or final rule pertaining to the subject of the “bulletin.”
3. A cost-benefit analysis of the “bulletin,” including an accounting statement showing the department’s assessment of the benefits, costs and transfers associated with this regulatory action as well as the economic impact analysis associated with this “bulletin.”
4. All documents, e-mails and data pertaining to the cost-benefit analysis and the economic impact analysis of implementing the essential health benefits “bulletin,” including any unfunded mandates on the states and the private sector and any regulatory alternatives considered by the administration.
5. A commitment that the administration staff will brief Congress in the future before briefing lobbyists and special interest groups on important issues relating to implementation of the health reform law.
"The information requested by the Republican chairmen and ranking members will help ensure the public is fully informed of the consequences of the recent health care law," according to a statement issued by the Republican congressional leadership.
Related Article:
HHS to Give States More Flexibility to Set 'Essential Health Benefits,' SHRM Online Benefits Discipline, December 2011
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