Coalition Urges HHS to Consider Affordability for Employers in Developing the Essential Benefits Package

Upcoming Rule on Essential Health Benefits Should Follow IOM Recommendations Regarding Affordability, Treatment of State Mandates and Updates to the Package

WASHINGTON, Dec. 2, 2011 /PRNewswire-USNewswire/ -- Upon the conclusion of the Department of Health and Human Services' (HHS) regional listening sessions on an essential health benefits package, employers, providers and other health care stakeholders urge HHS to heed concerns regarding the paramount need to keep the package affordable for businesses and individuals, as recommended by the Institute of Medicine (IOM).

"The rising cost of health care is the most significant barrier to individuals obtaining and employers providing health coverage today.  With businesses and families alike struggling in an uncertain economy, regulations that further increase costs of health coverage will not only have a negative impact on its affordability, but will also negatively affect employers' abilities to create jobs and increase workers' wages, while at the same time increasing costs for taxpayers," said Neil Trautwein, vice president of employee benefits for the National Retail Federation and chairman of the Essential Health Benefits Coalition.  "The IOM recognized the importance of keeping health coverage affordable.  We urge HHS to follow the IOM's advice.  HHS should develop an essential benefits package that is affordable, solid but flexible, and is evidence-based."

Health care costs have risen sharply during the past decade.  According to the Kaiser Family Foundation, average annual health insurance premiums more than doubled from $4,819 to $10,944 for employers and from $1,619 to $4,129 for workers since the year 2000.  (Kaiser Family Foundation "2011 Employer Health Benefits Survey).  Every new benefit mandate comes at a cost.  According to the Centers for Medicare and Medicaid Services, the growth in premiums from 2000-2010 tracked directly with the growth in required benefits.

In addition to keeping affordability a top concern, the coalition believes HHS should also follow the IOM's recommendations for the treatment of state benefit mandates and the basis for making updates to the package.  This includes:

• Ensuring state benefit mandates do not receive any special treatment and are subject to the same evaluative methods as all other elements of the package.
• Ensuring the model for updating essential benefits is based on sound evidence regarding the effectiveness of treatments and services and their cost. 

"The IOM has made thoughtful recommendations that acknowledge that the essential health benefits package must strike a careful balance between affordability and comprehensiveness of coverage.  We will continue to work with the administration toward the shared goal of reaching this balance," said Trautwein.

The Essential Health Benefits Coalition is a broad-based organization composed of groups representing large and small employers from various sectors of the U.S. economy, pharmacy benefit managers, and health plans operating in nearly every state.  The growing membership of the coalition includes the National Retail Federation, U.S. Chamber of Commerce, National Federation of Independent Business, National Association of Manufacturers, National Association of Wholesaler-Distributors, National Association of Health Underwriters, Blue Cross and Blue Shield Association, Retail Industry Leaders Association, Prime Therapeutics, America's Health Insurance Plans, ExpressScripts, Pharmaceutical Care Management Association, American Osteopathic Association and National Association of Dental Plans.

To learn more, visit the coalition's website at www.EHBCoalition.org.

SOURCE Essential Health Benefits Coalition