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The Department of Health and Mental Hygiene

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DHMH Press Releases : Maryland's Essential Health Benefit Plan



ANNAPOLIS (September 27, 2012 ) - Today, Lt. Governor Anthony G. Brown presided over a meeting of the Maryland Health Care Reform Coordinating Council (HCRCC) in Annapolis. The Council, co-chaired by Lt. Governor Brown and Department of Health and Mental Hygiene Secretary Dr. Joshua M. Sharfstein, reviewed options for the state’s essential health benefits benchmark plan that will define the "essential health benefits" to be covered in all plans sold in the small group and individual markets in Maryland for two years beginning on January 1, 2014. After reviewing ten eligible options, the Council voted to select the State Employee Plan as the State’s essential health benefit benchmark plan.

"By selecting the State's benchmark for its essential health benefit plan, Maryland is continuing its leadership in implementing health care reform," said Lt. Governor Brown. "I want to thank the 27 members of the Essential Health Benefit Advisory Committee, who took the time to analyze the benefits of each plan to ensure that Marylanders have the best, most affordable coverage available."

The Council’s action today gives effect to the Affordable Care Act’s requirement that beginning in 2014, every insurance policy sold in the individual and small group health insurance markets must cover a core set of essential health benefits. Rather than setting a national standard for these benefits, the federal government has adopted a 2-year transitional policy whereby states must select a health benefit plan from a menu of ten options already sold within their state to serve as the benchmark plan. The benefits covered by the benchmark plan will be the state’s essential health benefits.

"This is one critical step in the effective implementation of the Affordable Care Act in Maryland," said Dr. Sharfstein. "We are grateful for the valuable input from stakeholders and council members."

The Maryland Health Benefit Exchange Act of 2012 delegated to the Council the task of selecting the State’s benchmark plan by the October 1 federal deadline. Through a technical assistance grant from the Robert Wood Johnson Foundation, the Council obtained an expert analysis comparing the ten plan options. To ensure robust public input, the Council also appointed an Essential Health Benefits Advisory Committee made up of a broad range of diverse stakeholders to provide feedback and facilitate oral and written public comment. The Advisory Committee then submitted a report which summarizes and offers comment on the differences between the options to assist the Council in its decision.

“We are pleased with the Council’s selection today of the State employee plans. The selection reflects the views of the majority of stakeholders and will provide Marylanders a comprehensive set of benefits," said the Co-Chairs of the Essential Health Benefits Advisory Board, University of Maryland physician Dr. David Stewart and Calvert Memorial Hospital President and CEO Jim Xinis.

The Health Care Reform Coordinating Council was created by Governor Martin O’Malley through Executive Order in March 2010 to advise the administration on policies and procedures to implement the recent federal health care reform legislation as efficiently and effectively as possible. As states assume the critical role of implementing multiple aspects of health care reform, the Council will make policy recommendations and offer implementation strategies to keep Maryland among the leading states in expanding quality, affordable health care while reducing waste and controlling costs.

Lt. Governor Brown leads the O’Malley-Brown Administration’s efforts to reduce costs, expand access, and improve the quality of care for all Marylanders. Under the leadership of Governor O’Malley and Lt. Governor Brown, Maryland has implemented reforms that have expanded health coverage to over 341,000 Marylanders, half of whom are children, established Maryland’s Health Benefit Exchange, and put the State in position to maximize the Affordable Care Act (ACA). Independent analysis by the Hilltop Institute at the University of Maryland Baltimore County has found that implementation of the ACA will benefit the state’s budget by $672 million through 2020, generate more than $3 billion in annual economic activity, cut the number of uninsured in half, and create more than 26,000 jobs.


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