Essential health benefits (EHBs) targeted for cuts in reform debate represent a small share of total monthly premiums.
Analysis shows the EHBs covered under the Affordable Care Act (ACA), and targeted for cuts in repeal and replace legislation, represent less than 10 percent of total monthly premiums.
Benefit requirements targeted for cuts account for a small share of premiums—maternity and newborn care account for six percent; habilitative and rehabilitative care, two percent; and pediatric dental and vision care, one percent.
Largest shares of premiums come from services generally seen as fundamental to health insurance—office-based care (30%), prescription drugs (22%), outpatient facility care (17%), and inpatient care (15%).
If maternity and newborn care were cut from EHBs—meaning only users of these services would finance the costs now covered by insurance—the additional premium cost would be $13,888 annually.
The per-person costs of insuring EHBs are reasonably low, and account for small percentages of the overall premium when the costs are spread broadly across a large population with diverse ages and health care risks. Experts note that placing the costs fully on the users of health care can make those services unaffordable for those who need them.
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