Supplemented Blue Cross plan recommended as essential health benefits benchmark

Report says state's largest small group plan should be supplemented by pediatric oral and vision benefits

0 | Health Reform, Insurance

— State insurance regulators have forwarded their recommendation to Gov. Sam Brownback on what basic benefits should be available to Kansans who seek health insurance through the new online purchasing exchange that federal officials expect to be operational here within about 16 months.

In a report submitted to Brownback Monday, Insurance Commissioner Sandy Praeger said Kansas should use as its benefits benchmark the Blue Cross Blue Shield of Kansas Comprehensive Plan — the state's largest small group plan by enrollment — supplemented by required pediatric oral and vision benefits as currently provided in the state under Medicaid.

The report noted that Blue Cross currently provides coverage to 900,000 Kansans, operates in all but two of the state's 105 counties, and includes all hospitals and most other providers in its network.

If adopted by the governor, the recommendation would constitute what basic or "essential" benefits should be included in all plans marketed through the insurance exchange slated to be operational in 2014 as part of the 2010 federal health reform law.

Federal officials have left it to governors to choose which plan will be the benchmark in each state and have said they want those choices made by the end of the month. In the event a governor does not make a selection, the benefits will be decided by federal health officials.

Brownback, among the Republican opponents of what is commonly known as Obamacare, has said he will have no part in implementing the law until after the November presidential election. GOP presidential hopeful Mitt Romney has vowed to repeal the law as a first order of business, if elected.

Spokesmen for the governor reiterated his stance earlier this month.

"As the governor has said on multiple occasions, all decisions relating to the implementation of Obamacare will be made after the November elections," said chief spokesperson Sherriene Jones-Sontag.

Praeger and others have said they prefer a model selected by Kansans rather than one decided in Washington.



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