Hill Republicans Demand Answers of HHS on Essential Health Benefits Bulletin Procedure

Kicking off the election year of 2012, leading Congressional Republicans have fired off a letter to the U.S. Department of Health and Human Services Secretary Kathleen Sebelius questioning her use of a bulletin last month rather than a proposed rule to describe essential health benefits standards. 

They argued that by issuing a bulletin instead of a proposed rule, the Administration “sidestepped” the more arduous process of publishing a cost benefit analysis estimating the impact of the mandates  on health insurance premiums.

The matter smacks of avoidance of hard economic issues relating to health care costs to the Congressmen, who refer to the Patient Portection and Affordable Care Act as Obamacare.

“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 a proposed rule is the antithesis of an ‘open and transparent’ process,”  the Congressmen wrote

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, Senator Mike Enzi, R-Wyo., Ranking Member on the Senate Health, Education, Labor and Pensions (HELP) Committee, and Senator Orrin Hatch, R-Utah, Ranking Member on the Senate Finance Committee.

The bulletin does not have the force of law, and Congressmen said it could increase health insurance premuims and state spending on health care without clarity, putting states in a bind as their legislative sessions begin.

Upton's committee released the letter and has also been demanding information from the states, via the NAIC work on medical loss ratio rule development, about HHS' process and input. A resposne is expected sometime this month from the NAIC, although Upton asked for the information before the holdiays, but the NAIC is busy putting things together for a comprehensive letter. 

The Center for Consumer Information and Insurance Oversight (CCIIO) an  arm of the HHS, said in an Essential Health Benefits Bulletin released Dec. 16 that major medical benefits standards should reflect the benefits typically offered by small employers.

The CCIIO, says HHS officials have accepted the recommendations made by a panel of experts at the Institute of Medicine (IOM), Washington, that the EHB should"balance comprehensiveness and affordability for those purchasing coverage."

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