ACA essential health benefits come under threat

Before the Affordable Care Act, services such as maternity care, mental health care, and vision and oral health care for kids were often missing from state individual markets or only offered as expensive insurance riders.

That all changed with the ACA, which required that all individual market insurers cover “essential health benefits,” a defined set of basic health services that consumers have access to under their health coverage.

Since the requirement kicked in, research has documented positive change. For example, studies show that post-ACA, use of mammography has increased among all economic population groups, including the poorest patients. More patients are getting vaccinated against human papillomavirus, and out-of-pocket costs for prescription drugs have decreased nearly 30 percent.

While the essential health benefits have been welcomed by consumers and public health advocates, they are now under threat. A handful of federal policy proposals on the table could undermine the benefits rule and make comprehensive coverage less accessible and affordable — and take a major step backward for public health.

Continue reading this story from the May 2018 issue of The Nation’s Health.

Photo at top: Preventive health services such as vaccinations are considered an essential health benefit and covered under the Affordable Care Act. Photo by Michele Late, courtesy APHA