The Department of Health and Human Services is about to get a key report it will need to move ahead on one of the most important ? and politically sensitive ? health reform regulations it has to write: the rule spelling out what ?essential benefits? health plans will have to cover.
But there?s some speculation in health policy circles that HHS might not release the rule ? at least in final form ? until after the 2012 elections. And even if the department decides to issue the rule sooner, officials will still have to make a series of critical decisions on how specific it should be about what diagnoses, services and products must be covered.
Continue ReadingWithin weeks, HHS is supposed to get a report from the Institute of Medicine that will recommend the methods the department should use for deciding the requirements for a benefits package.
Once HHS has the report, officials will have to decide when the rule should come out. Officially, HHS can?t make any decisions before then, but well-placed health experts divide into two schools of thought: Either the rule is mostly written and HHS will issue it as soon as possible after receiving the IOM report, or they will wait until after the 2012 elections to avoid a political land mine.
?If I were a betting person, I would say we wouldn?t see anything final until November [or] December 2012,? said a longtime Washington hand. ?Why jump into this thing until you really have to? It will be demagogued no matter what.?
The political pitfalls are several: Requiring a generous benefit package will make insurance premiums more expensive. But a minimal package might anger consumer groups worried that those who carry this insurance will be underinsured.
And states that already have extensive coverage mandates could be concerned about a rule with less generous benefits. That?s because the law will obligate states to use their own dollars to subsidize any benefits that go beyond those required by federal law. So if those states require more coverage, they?ll have to make up the difference.
But Sara Rosenbaum, chairwoman of The George Washington University Health Policy Department and a reviewer of a preliminary IOM report on essential benefits, said the political dynamics argue for getting the rule out as quickly as possible.
?I don?t want to make it sound like the last days of Pompeii here, but it?s always possible for a president to lose the election, and you don?t want a proposed rule out there that a new administration could pull back,? Rosenbaum said.
An HHS spokesman would not comment on how the department might deal with the decisions.
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