Regulatory Updates
CMS Issues RFI on Review of Essential Health Benefits Framework and Typical Employer Plan Standard; Comments Due July 15
Published June 16, 2026
The Department of Health and Human Services (HHS) through the Center for Medicare & Medicaid Services issued a request for information (RFI) seeking public input to support the CMS' 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.
CMS seeks comment 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 ACA; and
- Variation across States in the scope of benefits included as 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.
The information gathered will inform CMS’ evaluation of whether revisions or additions to the current EHB regulations through future notice and comment rulemaking may be appropriate.
Comments are due July 15, 2026.