What: On June 15, 2026, the Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) seeking public input to support a comprehensive review of the Essential Health Benefits (EHB) framework and the requirement under the Patient Protection and Affordable Care Act (ACA) that the scope of EHB be equal to the scope of benefits provided under a typical employer plan.
Why: The information gathered will inform CMS’s evaluation of whether revisions or additions to the current EHB regulations through future notice and comment rulemaking may be appropriate.
CMS seeks comments on:
- Current interpretations of EHB, state approaches to selecting and updating EHB-benchmark plans, and methodologies used to determine the scope of benefits included as EHB, as well as how these approaches relate to access and market stability under the ACA.
- State variations in the scope of benefits included EHB, cost pressures affecting EHB, processes for updating state EHB-benchmark plans, limitations in available data used to evaluate EHB, and potential impacts of possible future policy changes.
Action: Read the RFI and submit comments before the July 15, 2026, deadline.
REQUEST FOR INFORMATION:
Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard
CONTACT:
Will Purcell
EMAIL:
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