Updated March 26 at 6:25pm

Hittner discusses R.I.’s mandated benefits in light of Trump plan to replace ACA

Dr. Kathleen Hittner, R.I. health commissioner, recently provided some insight into Rhode Island’s mandated benefits and what the future might hold in light of plans pushed by the GOP-controlled Congress and President Donald J. Trump to repeal and replace the Affordable Care Act.

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Hittner discusses R.I.’s mandated benefits in light of Trump plan to replace ACA

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PROVIDENCE – Dr. Kathleen Hittner, R.I. health commissioner, recently provided some insight into Rhode Island’s mandated benefits and what the future might hold in light of plans pushed by the GOP-controlled Congress and President Donald J. Trump to repeal and replace the Affordable Care Act.

In the state Office of the Health Insurance Commissioner’s most recent newsletter, Hittner acknowledged that Rhode Island has many mandated benefits – from treating Lyme disease and home health services to infertility treatments, among others. Those benefits, she said in the newsletter, “are one reason we did not see the huge spikes in premium increases that many other states experienced when the [ACA] took effect – many of the ACA’s Essential Health Benefits had already been in place in Rhode Island for more than a decade.”

OHIC’s study, conducted in 2014, found that no single mandated benefit significantly drives insurance premium increases, Hittner said. Citing the example of infertility treatments – one that is not mandated under the ACA – Hittner said that repealing that mandated benefit would amount to only $1.29 per insured, per month; that benefit is among the most expensive benefits that are not deemed an Essential Health Benefit under federal law.

Without knowing what Essential Health Benefits might be included in any ACA replacement, Hittner recommended policy makers consider these principles, when evaluating benefit mandates prospectively and retroactively. Mandated benefits should:

  • As much as possible, be consistent with practices in the self-insured market and Medicaid;

  • Be based on medical evidence;

  • Consider the cost impact of having or not having such benefit, from the perspectives of the state, payers and consumers; and

  • Not duplicate federal mandated benefits.

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