From the WASHINGTON POST:
…Defining essential health benefits poses a basic conflict. On one hand, everyone wants broad coverage; on the other, the broader the coverage, the more expensive policies will be — pushing government spending up (because government pays for the subsidies) and wages down (because employers will shift compensation from wages to fringe benefits).
[Health and Human Services secretary] Sebelius ducked this question by requiring each state to define essential health benefits based on existing policies in that state. Almost no one anticipated this. The ACA does not suggest it. Sebelius asked for advice from the nonpartisan Institute of Medicine. Its report talks of a national standard for essential health benefits, although it also notes that the ACA allows the secretary to provide state-by-state waivers beginning in 2017.
Politically, Sebelius’s decision is a masterstroke. One Republican criticism of Obamacare is that it imposes a “one-size-fits-all” straitjacket on health care. Mitt Romney — the ex-governor of Massachusetts and author of that state’s universal health insurance plan — has made this point repeatedly. President Obama can now retort: “No, we’ve left crucial decisions to the states.” He can also argue that Washington isn’t dictating “how medicine should be practiced.”
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