Setting a National Minimum Standard for Health Benefits: How Do State Benefit Mandates Compare with Benefits in Large-Group Plans?
Allison Frey, M.P.P, Stephanie Mika, Rachel Nuzum, M.P.H, and Cathy Schoen, M.S.
Many proposed health insurance reforms would establish a federal minimum benefit standard—a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require—indicating that a broad-based national benefit standard would include most existing state benefit mandates.
A. Frey, S. Mika, R. Nuzum, and C. Schoen, Setting a National Minimum Standard for Health Benefits: How Do State Benefit Mandates Compare with Benefits in Large-Group Plans?, The Commonwealth Fund, June 2009.