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Haslam administration collecting input on state's needs for health care

August 1st, 2012 2:14 am by Hank Hayes

KINGSPORT -- Tennessee Gov. Bill Haslam's administration collected input Tuesday that will lead to an upcoming critical decision on health insurance coverage scheduled to go into effect in 2014.


Commerce and Insurance Commissioner Julie Mix McPeak conducted an outreach meeting at the Kingsport Renaissance Center to gather feedback about health conditions that should be covered in an essential health benefit (EHB) package under the federal Affordable Care Act.


"Under health care reform, states must determine which health conditions should be covered under essential health benefit categories," McPeak told a small gathering of health care providers and other interested parties.


The selected benchmark EHB plan would serve as a reference plan, reflecting both the scope of services and any limits offered by a "typical employer plan" in Tennessee, according to the National Conference of State Legislatures.


The EHB plan would be the insurance product included in individual and small-employer group health insurance plans offered on or after Jan. 1, 2014.


"The (EHB) plan we select will be the minimum level on the commercial market side," McPeak explained.


The Haslam administration must select Tennessee's benchmark EHB plan on or before Sept. 30.


EHB is expected to include items and services within 10 defined benefit categories -- ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services including oral and vision care.


At the outreach session, registered dietitian Laura Dyck advocated health insurance coverage for nutrition care to combat obesity.


"A lot of insurances these days do not cover nutrition counseling, and we feel very strongly as a preventative measure it is of utmost importance," Dyck said.


McPeak said the EHB issue is separate from the possible expansion of TennCare, the state's Medicaid program, or the possibility the state may have to run a health insurance exchange.


However, she added federal law says the coverage tiers in the health insurance exchanges have to have 60 percent to 70 percent of the essential health benefits.


Tennessee's three largest small market health insurance group products are offered by Blue Cross/Blue Shield and UnitedHealthCare Insurance Co., according to the federal government.


Under the Affordable Care Act, self-insured group health plans, large group plans and grandfathered health plans are not required to offer EHB, according to the federal government.


To make a public comment about the state's decision, send an e-mail to: PubComm.HRF@tn.gov.


For more information on the decision go to www.tn.gov/commerce/insurance/ehb/health_essentials.shtml.

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