The Department of Health and Human Services (HHS) and the Center for Medicare and Medicaid Services (CMS) released a final rule on the 2019 Notice of Benefit and Payment Parameters. AKF submitted a comment letter in November in response to the proposed rule. We focused our comments on the proposed changes in defining the essential health benefits (EHB) package, expressing our concern that the changes could weaken the level of meaningful health coverage available to individuals with a chronic disease.

In the final rule, CMS finalized its proposals in allowing states greater flexibility in defining their EHB benchmark plan, with certain adjustments from the proposed rule. CMS delayed the effective date to the EHB changes to the 2020 plan year, instead of 2019. Also of note, CMS acknowledged that due to the changes, “Consumers who have specific health needs may also be affected by the policy… depending on the selection made by the State in which the consumer lives, consumers with less comprehensive plans may no longer have coverage for certain services. In other States, again depending on State choices, consumers may gain coverage for some services.”