The Value of Federalism in Defining Essential Health Benefits

The promise of nearly universal health insurance coverage embodied in the Affordable Care Act (ACA) has meaning in part because it is tied to a minimum set of covered services called essential health benefits (EHBs). Health and Human Services Secretary Kathleen Sebelius surprised the health care community when, on December 16, 2011, she announced that there would not be one single national definition for EHBs.1 Rather, each state will have 10 options to choose from in defining the EHBs, 7 of which are tied to existing coverage in that state's small-group, state-employee, and health maintenance organization markets. Although critics of . . .