As Community Catalyst releases its 12 Days of Enrollment, we also wanted to remind you of a few of our favorite things. At the top of our list is the essential health benefits package (tied up with string). Why? Because as we near January 1, these new benefits become a reality for individuals and families across the country. EHB promises a new robust foundation for health coverage that encompasses a full range of benefits including many that were previously excluded from plans in the individual and small group insurance market. For many, this is the best holiday gift they could imagine.
Now that these benefits are required of individual and small group market products —both inside and outside of state and Federal marketplaces—the devil is in the details. The implementation of EHB is the first step in building robust coverage for consumers but it is not the last. Come January 1, we will begin to see how consumers access their new benefits and better understand if those benefits meet their health care needs.
We are mindful that as individuals, children and their families transition into these new plans, little is known about how they will work for consumers. We must be vigilant in monitoring how plans are working for consumers. This is where advocates will play a key role. But how can we possibly think about monitoring as we are busy enrolling through March? A couple of things to keep in mind:
Departments of Insurance continue to play a lead role
Departments of Insurance are largely responsible for reviewing whether or not plans meet the EHB standard. Advocates can continue building a relationship with their DOI, reminding them of their obligation to protect consumers. In turn, DOIs need to hear from consumers and advocates can support this feedback from the ground.
Consumers are likely to reach out to enrollers
Many consumers are currently engaged in plan selection; they are identifying a plan that meets both their health and financial needs. And many are turning to those individuals in their states who are assisting with enrollment. Enrollers are important partners in not just enrolling consumers in coverage, but directing consumers where to go when plans are not working for them.
Coalitions can continue to impact EHB
Many advocacy groups worked together to secure a robust EHB in their state. This group can continue to play a role. Many of those who were engaged in the state EHB selection are also groups with ties to consumers – they play an important role in monitoring how consumers are accessing care and whether plans are providing a robust benefit that meets their health needs. These partners have the opportunity to transmit what is happening on the ground to state and federal officials.
Community Catalyst released an EHB toolkit on key issues and advocacy strategies. This toolkit provides you with an overview of areas to monitor, an advocacy timeline, and strategies for engaging coalitions, collecting stories, and working with DOIs to enhance EHB.
We want consumers to have access to robust coverage, which many people have been denied for a very long time. Additionally, a robust benefit framework brings economic security to all. It is the security of knowing that a health event will not destroy a family’s finances or strap an individual with medical debt. Most importantly, the EHB does not discriminate – it recognizes us all as equals deserving in access to important benefits that keep us all healthy. And that is the greatest gift of all.