The chiropractors did succeed in securing a seat on the advisory board weighing Maryland's essential health benefits. In California, however, they ran into trouble when the legislature passed a benefit package that may exclude chiropractors from delivering services.
Some states are still debating whether they want to set a benchmark package at all. If they do not, the federal government will default to the benefits of the largest insurance plan in the state's small-group market.
Kansas Gov. Sam Brownback has decided against defining his state benefit package as his administration has decided not to "make any decisions regarding the implementation of the Obamacare until after the November elections," according to spokeswoman Sherriene Jones-Sontag.
It is less clear what happens if a state passes a benefit package that does not provide adequate coverage of the 10 categories outlined in federal law.
Utah has alarmed some advocacy groups by approving a plan that does not appear to specify a substance abuse benefit, even though the federal law requires one.
They have also questioned whether Utah's dental benefit, beginning coverage at age 3, will meet the federal mandate to provide pediatric dental coverage.
"Our concerns could be allayed if the federal government takes a strong position and pushes back about how they'll treat these," said Lincoln Nehring, a senior health policy analyst at Voices for Utah Children. "Since there's some uncertainty about how they'll treat these, that does cause us a fair amount of angst."