Thousands Criticize IOM Report on ‘Essential Benefits’ in Exchanges
More than 2,400 physicians, health policy experts and executives signed a letter sent to HHS Secretary Kathleen Sebelius on Thursday urging the federal government to reject recommendations by the Institute of Medicine on how to define "essential benefits" in state health insurance exchanges under the federal health reform law, Modern Healthcare reports (Robeznieks, Modern Healthcare, 12/1).
Background on Essential Benefits
Under the federal health reform law, states by January 2014 must create exchanges that provide coverage options for individuals and small businesses. States can choose to administer their own exchanges -- for which they must have some infrastructure in place by January 2013 -- or ask the federal government to run the exchanges for them.
In October, an IOM committee released its recommendations to HHS on how the basic coverage standards for the exchanges should be established and emphasized that affordability should be the agency's main priority (California Healthline, 10/7).
Details of Letter
The letter -- which was circulated by the Physicians for a National Health Program, a single-payer advocacy group -- said the recommendations focus more on "cost rather than medical need" (Modern Healthcare, 12/1). It added that adopting the recommendations "will sacrifice many lives and cause much suffering" (Baker, "Healthwatch," The Hill, 12/1).
Patients need "universal and comprehensive coverage in a nonprofit system that prioritizes human need over corporate profit," the letter noted (Modern Healthcare, 12/1). According to "Healthwatch," the letter suggests that many of the IOM panel's members had financial conflicts of interest as they had ties to insurers ("Healthwatch," The Hill, 12/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.