{"database": "press", "table": "releases", "rows": [["https://www.warner.senate.gov/public/index.cfm/pressreleases?ID=2492AAE1-960E-4EAA-B919-0964AFE927B4", "Warner, Smith Lead Colleagues in Urging a Formal Review of Essential Health Benefits", "2022-10-04", "2022", "2022-10", "Democrat", "Senate", "VA", "Mark R. Warner", "W000805", "www.warner.senate.gov", "warner", "https://www.warner.senate.gov/public/index.cfm/pressreleases", "scraper", "WASHINGTON \u2013 Today, U.S. Sens. Mark R. Warner (D-VA) and Tina Smith (D-MN), joined by Sens. Amy Klobuchar (D-MN), Tammy Baldwin (D-WI), Michael Bennet (D-CO), Chris Murphy (D-CT), Bernie Sanders (I-VT), and Cory Booker (D-NJ), sent a letter to Department of Health and Human Services and Centers for Medicare & Medicaid Services (HHS/CMS) leadership urging them to review and formally report on the adequacy of the Affordable Care Act\u2019s Essential Health Benefits (EHBs). The letter expressed the need for a review of telehealth flexibilities and the impact that scaling back these service options will have on those who rely on telehealth capabilities for treatment.\n\n\u201cAs we begin to envision health care policies post-pandemic, we remain concerned telehealth services will be significantly pared back, hindering access to care for millions of Americans\u2014especially those with complicated health conditions,\u201d the Senators wrote.\n\nWhen the Affordable Care Act was enacted, it required the Secretary of HHS to review EHBs and provide a report to Congress, and the public, that contains:\n\nAn assessment of whether enrollees are facing any difficulty accessing needed services for reasons of coverage or cost;\n\nAn assessment of whether the EHBs list needs to be modified or updated to account for changes in medical evidence or scientific advancement;\n\nInformation on how EHBs will be modified to address any such gaps in access or changes in the evidence base;\n\nAn assessment of the potential of additional or expanded benefits to increase costs and the interactions between the addition or expansion of benefits and reductions in existing benefits to meet actuarial limitations;\n\nDespite this requirement, this formal review and report have never been undertaken or completed. The Senators stressed the need for this process in light of changes being made to care as the health care system shifts to a post-pandemic structure.\n\n\u201cWe have heard from constituents who have concerns that coverage will start to vary based upon visit modality. For some specialized, complicated care\u2014eating disorders, for example\u2014it has always been challenging getting the most appropriate treatment covered, whether that\u2019s because of parity or network issues,\u201d the Senators continued. \u201cWe are concerned that modality will become one additional way barriers to treatment will be enacted, if arbitrary in-person requirements become one more way care is denied or delayed.\u201d\n\nThe full text of the letter is available here and below:\n\nDear Secretary Becerra, Administrator Brooks-LaSure and Deputy Administrator Montz:\n\nWe thank you for your continued partnership in establishing and extending telehealth flexibilities to ensure Americans have access to vital health care services and supports over the course of the COVID-19 pandemic. As we begin to envision health care policies post-pandemic, we remain concerned telehealth services will be significantly pared back, hindering access to care for millions of Americans\u2014especially those with complicated health conditions.\n\nAccording to federal statute, it is incumbent upon the Secretary to periodically review insurance plan Essential Health Benefits (EHBs) and provide a public report to Congress that contains 1) an assessment of whether enrollees are facing difficulty accessing needed services for reasons of coverage or costs; 2) an assessment of whether plan benefits need to be modified or updated to account for changes in medical evidence or scientific advancement; 3) information on how plan benefits will be modified to address any such gaps or changes in the evidence base; and 4) an assessment of potential of additional or expanded benefits to increase costs and the interactions between the addition of benefits and reductions in existing benefits.\n\nWe believe after 12 years of the ACA it is important that EHBs be formally reviewed and the mandated report be issued to the public and Congress, especially as your Administration is committed to maintaining and further strengthening the law\u2019s protections. We urge you to undertake such a review and report, and in addition we urge you to ensure that visit modality is not one of the \u201creasons of coverage\u201d for which \u201cenrollees are facing difficulty accessing needed services.\u201d\n\nWe have heard from constituents who have concerns that coverage will start to vary based upon visit modality. For some specialized, complicated care\u2014eating disorders, for example\u2014it has always been challenging getting the most appropriate treatment covered, whether that\u2019s because of parity or network issues. We are concerned that modality will become one additional way barriers to treatment will be enacted, if arbitrary in-person requirements become one more way care is denied or delayed.\n\nThe Department addressed a delay in completing such a report to Congress in its 2019 Notice of Benefit and Payment Parameter Final Rule, citing the need for further insurance market stabilization that the final rule would provide. Although we understand the difficulty of reviewing the markets as they continue to evolve, it is for that reason critical that the Administration review and report on EHBs so that we have an understanding of whether they continue to be adequate in an ever-evolving health care ecosystem. The health care system will not be the same after the COVID-19 pandemic, and this is an opportunity to renew our commitment to comprehensive, affordable and accessible health care coverage. We respectfully request this report be conducted and issued to Congress to inform future health policy to better serve Americans.\n\nThank you for your consideration, and we look forward to continuing to work with you on this very important issue.\n\n###", 1, "2026-03-30T01:40:41Z", "2026-04-06T18:34:28Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://www.warner.senate.gov/public/index.cfm/pressreleases?ID=2492AAE1-960E-4EAA-B919-0964AFE927B4"], "units": {}, "query_ms": 2.9500932432711124, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}