The federal government is taking on a crucial new role in the nation’s health care, designing a basic benefits package for millions of privately insured Americans. A framework for the Obama administration was released Friday.
The report by independent experts from the Institute of Medicine lays out guidelines for deciding what to include in the new “essential benefits package,” and how to keep it affordable for small businesses and taxpayers, as well as scientifically up to date.
The advisers recommended that the package be built on mid-tier health plans currently offered by small employers, expanded to include certain services such as mental health, and squeezed into a budget. They did not spell out a list of services to cover, but they did say that treatments should be cost-effective.
Until now, designing benefits has been the job of insurers, employers and states. But the new health care law requires insurance companies to provide at least the federally approved package if they want to sell to small businesses, families and individuals through new state markets set to open in 2014.
Existing workplace plans won’t be required to adopt the federal model, but employers and consumer advocates alike predict it will become the nation’s benchmark for health insurance over time.