FOR IMMEDIATE RELEASE
March 29, 2024
(202)-538-2836
WASHINGTON, D.C. – Today, U.S. Reps. Nanette Barragán (CA-44) and Angie Craig (MN-02), members of the Energy & Commerce Subcommittee on Health, led 18 of their colleagues in a letter to the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) in support of updating Essential Health Benefits (EHBs).
Included as part of passage of the Affordable Care Act, EHBs are a set of ten required services, including maternity and newborn care, mental health and substance use disorder services, and prescription drug coverage, that must be covered by Marketplace and some commercial insurance plans. However, the administration has not used its statutory authority to set a minimum standard of coverage under these categories or set a regular process for reviewing and updating coverage. With more than 20 million Americans enrolled in Marketplace coverage it is critical to set minimum standards to avoid gaps in coverage.
“As evident in the comments in response to the December 2022 CMS Request for Information on Essential Health Benefits, coverage varies greatly by state, with many states allowing for inadequate coverage across EHB categories,” wrote the Members. “… This Swiss cheese approach also contributes to the medical debt crisis our country is currently facing, where millions with health insurance have medical bills for services not covered by their insurance and they simply cannot afford to pay them.”
In the Notice of Benefit and Payment Parameters (NBPP) for 2025 Proposed Rule, HHS took an important step forward in addressing coverage gaps in EHBs. This letter applauds the Biden administration’s efforts to date in granting states greater flexibility to expand EHB coverage standards but also urges the administration to use the administrative authority granted by Congress to review and update the EHBs to ensure that everyone has access to the health care they need, regardless of where they live.
“Thirteen years after ACA passage, we are asking the administration to act in the spirit of the law and update the ACA’s standards to fill in crucial gaps and make health insurance coverage more comprehensive. Now more than ever, it’s time for HHS to act, as there are major inequities in the services covered, leaving far too many people underinsured resulting in high out-of-pocket costs and medical debt, or people foregoing important, needed care,” said Emily Stewart, executive director of Community Catalyst, a national health justice organization that has convened more than 50 local, state and national organizations urging the Biden administration to act. “With rising health care costs, and 4 in 10 adults with medical debt, it’s critical that policymakers continue to address the gaps and inconsistencies that exist – including for mental health, maternity and dental care. This is a simple yet important and long overdue action the Biden administration can take to improve coverage for millions of people across the country. We applaud the lawmakers urging action.”
In addition to Barragán and Craig, the letter was signed by Reps. Yadira Caraveo, Tony Cárdenas, Steve Cohen, Sylvia Garcia, Raúl Grijalva, Sheila Jackson Lee, Jonathan Jackson, Barbara Lee, Summer Lee, Zoe Lofgren, Eleanor Norton, Donald Payne, Katie Porter, Delia Ramirez, Adam Schiff, Melanie Stansbury, Mark Takano, and Jennifer Wexton.
The letter was endorsed by Community Catalyst, American Association on Health and Disability, Center for American Progress, Center for Law and Social Policy (CLASP), Colorado Children’s Campaign, Colorado Consumer Health Initiative, First Focus on Children, Justice in Aging, Lakeshore Foundation, Mental Health America, MomsRising, Ohio Federation for Health Equity and Social Justice, Partnership to End Addiction, Policy Center for Maternal Mental Health, Protect Our Care, Small Business Majority, Tennessee Health Care Campaign, The Kennedy Forum, Young Invincibles, and United States of Care.
The full text of the letter can be found here.
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Congressmember Nanette Barragán represents California’s 44th District. She sits on the House Energy and Commerce Committee and works on environmental justice and healthcare issues. She is also Chair of the Congressional Hispanic Caucus (CHC).