At least two dozen states missed Health and Human Services (HHS) October 1 soft deadline to submit their essential health benefit benchmark plans. Under the Affordable Care Act, health plans in the exchanges must provide coverage for 10 broad categories of benefits, such as ambulatory patient services, emergency services and pediatric services. The benefit requirements apply to newly eligible Medicaid beneficiaries and individual and small group plans sold in state-based exchanges.
HHS had set a soft deadline for states to submit plans for their health insurance exchanges. Nearly all the states that missed the deadline cited a lack of formal federal guidance as reason for the delay. For example, West Virginia Gov. Earl Ray Tomblin (D) submitted a letter to HHS Secretary Kathleen Sebelius requesting additional details on the law’s mandated benefits. He also complained about a lack of response from HHS on his earlier questions about the law’s Medicaid expansion requirement.
