The Implications of Eliminating Essential Health Benefits
Brief Nov-01-2020 | | 1-min read
The requirement that these essential benefits be included in ACA-compliant nongroup insurance coverage increases premiums beyond what they would be if people could purchase plans covering fewer benefits. This had made the requirements somewhat controversial and spurred interest in reducing or eliminating them among some insurers and policymakers; some have proposed allowing states to use waivers to reduce or eliminate essential health benefit requirements.
Eliminating or permitting states to waive an ACA provision that requires participating health insurance companies to cover 10 essential health benefits could contribute to thousands of dollars in new out-of-pocket expenses for patients.
Policymakers seeking to eliminate the ACA’s essential health benefits argue that paying for coverage for services, that some people may not use, unnecessarily raises costs for many. Though annual premiums may fall if essential health benefits coverage is eliminated, people who need these services could face thousands more in direct out of pocket costs as a result, likely leading to significantly higher levels of unmet medical need.
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