Throughout the debate leading up to passage of the health care bill last year, employers, health care providers, and consumers demanded that the legislation bend the health care cost curve. Clearly, the law has failed in this regard, as evidenced by news last week of sharply rising premiums.

Now, once again, the administration is being asked to address the affordability issue. A respected committee of health care policy experts recommends that the Department of Health and Human Services (HHS) focus on affordability as it begins to define what constitutes an “essential health benefits” package that all plans in the individual and small group markets and state-run health exchanges must adopt by 2014.

One member of the Institute of Medicine’s committee is quoted in the Washington Post:

“The question is what is the fairest, most transparent way to get a reasonable set of benefits and still keep it affordable for both the user and for the taxpayers,” said committee member Marjorie Ginsburg. “We don’t want to say that one is more important than the other. . . . But the limiting issue obviously is affordability.”

We’re pleased with IOM’s apparent emphasis on the need to balance coverage and cost. If the affordability issue is largely ignored, as it was in the crafting of the legislation, then plans serving the small group and individual markets will be forced to offer comprehensive coverage that few will be able to afford.

As HHS develops its definition of essential health benefits, it should never lost sight of these three words:

• Affordability.
• Flexibility.
• Accessibility.