The U.S. Department of Health and Human Services announced on December 16 that it is accepting comments from states on a new proposed approach to implement section 1302 of the Affordable Care Act (ACA), which requires that “qualified health plans” that will offer coverage in 2014 through health insurance exchanges cover at least “essential health benefits.”   Section 1302 requires that such benefits include items and services in at least ten broadly defined categories (emergency, hospitalization, maternity and new-born care, ambulatory, rehabilitative/habilitative, prescription drugs, pediatric, preventive/wellness and chronic disease management, mental health/substance abuse, and laboratory services). HHS is now proposing for the first time to let each state define “essential health benefits” if the state’s definition is based on private plans already available in the state (i.e., one of the three largest small group plans, one of the three largest plans serving state employees, one of the three largest plans serving federal employees, or the largest commercial HMO plan). States should find merit in this new proposal but should seek further clarification to ensure consistent understanding and proper implementation.  Comments and questions are due January 31.