By CARLA K. JOHNSON
AP Medical Writer

CHICAGO (AP) Illinois officials
chose a relatively lean small-group policy Friday as the benchmark plan for
essential health benefits in the state, another milepost in implementing
President Barack Obama’s health care law.

Gov. Pat Quinn’s health care
council approved Blue Cross Blue Shield’s Blue Advantage plan as the benchmark
at a meeting in Chicago. It will be submitted to the U.S. Department of Health
and Human Services, which will take public comment.

Ultimately, the
benchmark plan will determine the cost of future premiums and how broad coverage
will be for many Illinois patients.

To be sure, other health policies
will be sold in Illinois when much of the health care law takes effect in 2014.
But the benchmark acts as a minimum standard for the type of medical services
that must be covered in plans sold to individuals and small businesses under the
law.

“For most people, it does not matter. The truth is the health
issues that most people have or will have are covered by most any plan that
might have been a benchmark plan,” said attorney Ian Spatz of Manatt, Phelps
and Phillips, a law firm consulting with states and health care providers on
what critics have called “Obamacare.”

But, Spatz added: “What
Illinois doing is important. It’s informing the insurers in Illinois what they
have to begin to design to be offered in 2014.”

The Illinois governor’s
council also approved benchmarks for children’s vision and dental care, which
must be covered under the federal law, but aren’t currently covered by most
Illinois policies. The council chose a federal plan as a model for children’s
vision care and the state’s own All Kids coverage as the standard for children’s
dental care.

Obama’s health law set 10 basic categories that must be
covered by health plans, such as emergency services, prescription drugs and
maternity care. Children’s vision and dental care are on that list. Within those
categories, states determine a basic level of covered services and costs.

The Blue Advantage plan is one of the leaner small-group health policies
sold in the state, said Colleen Burns of the Illinois Department of Insurance.
It puts a $1,000 annual limit on care from chiropractors. It covers only
“medically necessary” weight-loss surgery. It doesn’t cover routine vision or
hearing exams for adults.

It does cover all the services that Illinois
law mandates, such as treatment for autism and infertility.

But it
doesn’t cover massage or acupuncture, for example, which disappointed Chicago
acupuncturist Tom Hurrle.

“We’re glad that this will be reviewed during
the next two years,” Hurrle said. There will be more recognition of acupuncture
as more research supports its cost-effectiveness, Hurrle said.

It wasn’t
the leanest plan evaluated by the state. That was United Healthcare’s Choice
Plus plan, which sets limits on substance abuse treatment, mental health
services and physical therapy. The governor’s office asked a group of doctors to
review the health policies under consideration, focusing on their service limits
and exclusions, Burns said.

The doctors “noted that if United
Healthcare’s Choice Plus plan became the benchmark, coverage could prove
insufficient in the event of serious medical events such as a stroke,” Burns
said.

“Under the Affordable Care Act, health insurance policies will
afford every American access to care under these 10 covered essential
services,” said Michael Gelder, Quinn’s chief health care adviser.

Gelder said that contrasts “with what happens today in an insurance
market where policies can be sold with a much more limited set of services that
are covered.”

AP Medical Writer Carla K. Johnson can be reached
at http://www.twitter.com/CarlaKJohnson