Essential Health Benefits (EHB) benchmarking process

Executive Summary

The Essential Health Benefits (EHB) benchmarking process has been significantly modified throughout the years to provide states with increasing flexibility to either make harmful cuts to coverage or improve coverage. The current benchmarking process, finalized in 2017, established a new ceiling on the generosity of benefits provided under the base-benchmark plan (BBP), but also created new opportunities for states to expand the number of services covered under each category. This fact sheet examines the new benchmarking process and explains the opportunities available for states looking to make improvements to their EHB BBP. The paper also provides examples of procedural and substantive best practices from states that have introduced changes using the new standard and that stakeholders and advocates should urge states to adopt.

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