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California hearing panel sets tight May 7 deadline to revise essential health benefits for 2027
Summary
At a Feb. hearing, state health officials and actuaries warned the Legislature that federal rules and a typicality test limit how much the state can expand its essential health benefits (EHBs) for the 2027 plan year; staff said a submission to CMS must be filed by May 7 for changes to take effect Jan. 1, 2027.
Assemblymember Mia Bonta and Senator Carolyn Menjivar convened a joint informational hearing on Feb. 11 to review options for updating California’s essential health benefits benchmark for the 2027 plan year and to get stakeholder input.
The hearing focused on process and timing: Department of Managed Health Care Director Mary Watanabe and Wakely actuaries explained that federal regulations require the state to submit a complete package to the Centers for Medicare & Medicaid Services (CMS) by early May if any new benefits are to take effect Jan. 1, 2027. "We do need to have an effective date of January 1," Watanabe said, adding the May filing deadline "is a very aggressive timeline, with some tough decisions ahead of us." The department said it aimed to identify a draft package for public comment in mid-February and anticipated two public comment windows before a May submission.
Why it matters: the Affordable Care Act permits states to select a benchmark plan that defines the EHBs…
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