IOM Issues Perspectives on Essential Health Benefits

The Affordable Care Act requires that certain coverage must be included in the essential health benefits (EHB) package offered by qualified health plans that are certified by an exchange. Beginning in 2014, in the individual and small group markets, the EHB provided must equal benefits provided under a “typical” employer-sponsored plan. The U.S. Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend the criteria and methods for determining and regularly updating the EHB package. IOM is expected to release a final report with its recommendations in September. Public workshops were held earlier this year where experts from federal and state governments, employers, insurers, health care providers, consumers and health care researchers discussed topics such as the need to balance the generosity of EHB with affordability of insurance coverage. IOM has released a report with summaries of the workshops. The summaries contain the opinion of presenters and do not reflect the conclusions of IOM. The report is available at Contact: Anne McLeod, (916) 552-7536,