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States will be given wide latitude to decide what "essential benefits" insurers must offer in policies offered on new health exchanges come 2014, the Obama administration said Friday in a move that pushes off final federal rules on those benefits until sometime next year.
Just as Walmart and other retailers shook up the pharmacy business by offering $4 generic drugs, the industry now aims to apply its clout to tackle unpredictable costs, a lack of primary care doctors and inefficient management of chronic illnesses.
According to confidential documents obtained by KHN, Walmart is seeking to become the largest provider of primary health care in the United States in order to "lower the cost of health care." Analysts say Walmart could also be trying to get more people in their stores.
The case brought by Anthem Health Plans of Maine could have regulatory repercussions around the country.
KHN staff writers Julie Appleby and Mary Agnes Carey report that federal officials have effectively shut down part of the health care law aimed to help consumers pay for long-term care.
The Department of Health and Human Services now must decide what benefits should be required in policies sold through insurance exchanges beginning in 2014.
An annual survey has found that the average cost of a family health insurance plan rose 9 percent this year - triple the growth rate seen in 2010. KHN's Julie Appleby filed this story.
Businesses want employees to be more sensitive to the cost of medical care, but consumer advocates worry that decisions will be based on price, not quality.
Employers struggling to keep down insurance costs are increasingly requiring workers to pay a percentage of high-cost drugs rather than a modest co-pay.
The federal health care law gives officials new tools to help hold down rates, but states' authority and political will still vary widely.
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