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8 Allowance for State Innovation
Pages 129-134

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From page 129...
... The statute is silent, however, regarding whether the Secretary could approve more than one EHB definition, provided that the statutory requirements are otherwise met. The committee believes that the Secretary therefore has the authority to approve refinements of the national EHB definition, if the Secretary chooses to do so, provided such definitions otherwise meet the requirements of Section 1302.
From page 130...
... Furthermore, the committee believes that the Secretary's approval of a state-specific variation of the EHB definition should be contingent on the state's developing a package with content that is actuari ally equivalent to the national package established by the Secretary during initial definition or updating; otherwise, state-specific variations of EHB could either substantially increase aggregate package costs or significantly reduce the intended scope of packages covered by the EHB. From a practical standpoint, state-specific EHB developed locally and with a credible, accountable public deliberation process are even more likely to gain sustained state-based public support than a single federal defini tion with no possibility of state-based innovation.
From page 131...
... . Provided that these programs and processes meet the minimum requirements set forth below, the committee believes that such preexisting, comprehensive processes with meaningful public input should be afforded deference as the Secretary considers whether to grant a request for a state-specific EHB definition.
From page 132...
... In developing these standards, the committee believes HHS would best meet its oversight obligations by recognizing the primary importance of states' demonstrating that they have the structures and processes in place to meet the standards, rather than the degree to which the resultant state package matches the federal package. For example, as HHS develops and applies these standards, the committee, as noted previously, has concluded that if a state already has established comprehensive basic benefit definition processes, as long as the results are consistent with the legislative requirements of Section 1302 and the committee's recommendation, then the state program should be granted deference in the state-specific approval process.
From page 133...
... 2011b. Preparing for innovation: Proposed process for states to adopt innovative strategies to meet the goals of the Affordable Care Act.


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