Conservative Republicans Demand That Essential Benefits Coverage Be Dropped
A core piece of Obamacare is the requirement that insurers offer plans that cover basic health services like maternity care, mental health services, prescription drugs and hospital care. Some Republicans seek to lower costs and have more choice for health insurance sold to individuals by rolling back those requirements.
The Wall Street Journal:
Basic-Services Requirement Is At Heart Of Health-Insurance Split
At the heart of the last-minute negotiations over the House GOP health-care bill is a pillar of the Affordable Care Act: the requirement that most insurance policies cover a basic set of health services, including such items as maternity and mental-health care. Repealing that requirement, as many conservatives want, would topple a core element of the ACA that sought to protect patients from the high cost of using a health service not covered by their insurance. (Armour, 3/23)
USA Today:
Dropping Obamacare's 'Essential' Benefits Impacts More Than Mammograms
Eliminating required health insurance benefits, a move discussed as part of the Republican move to repeal the Affordable Care Act, also threatens to kill the ACA's annual and lifetime limits on patients' costs, which was enacted to prevent bankruptcies due to medical costs. The limits on out of pocket costs only apply to the ACA-required 10 essential health benefits, which include prescription drugs and hospital care. So eliminating the benefit requirement makes the limits "essentially meaningless," says health care legal expert Tim Jost. (O'Donnell, 3/23)
Kaiser Health News:
Late Move To Dump ‘Essential’ Benefits Could Strand Chronically Ill
A last-minute attempt by conservative Republicans to dump standards for health benefits in plans sold to individuals would probably lower the average consumer’s upfront insurance costs, such as premiums and deductibles, said experts on both sides of the debate to repeal and replace the Affordable Care Act. But, they add, it will likely also induce insurers to offer much skimpier plans, potentially excluding the gravely ill, and putting consumers at greater financial risk if they need care. (Hancock, 3/24)
Los Angeles Times:
Obamacare 101: 4 Things You Need To Know About 'Essential Health' Benefits
Among the most important — and little understood — new insurance rules put in place by the Affordable Care Act was a requirement that health plans cover a basic set of benefits. The requirement was part of a package of new consumer protections in the healthcare law, including a prohibition on insurers denying coverage to people with preexisting medical conditions and bans on annual- or lifetime-limits on coverage, which were once common. (Levey, 3/23)
NPR:
Republican Health Bill Could Remove Pre-Existing Condition Protections
When House Speaker Paul Ryan says he wants to repeal the Affordable Care Act so that people can buy insurance that's right for them, and not something created in Washington, part of what he's saying is that he wants to get rid of so-called essential health benefits. That's a list of 10 general categories of medical care that all insurance policies are required to cover under the Affordable Care Act. Getting rid of that requirement, or trimming it, is central to the Republican strategy, because they say those benefits drive up insurance premiums so much that healthy people won't buy coverage. (Kodjak, 3/23)
Marketplace:
Conservatives Want The Government To Stop Mandating What Insurers Must Cover
The latest carrot that House leadership and the White House are using to win conservative Republican votes for the health care bill is repealing an Obamacare provision that standardized insurance policies. Under Obamacare, virtually all insurance policies cover things like hospitalization, mental health, prescription drugs and pregnancies – known as essential health benefits. But guaranteeing those benefits cost money, while doing away with them would drop the price of premiums. (Gorenstein, 3/23)
The Washington Post:
‘I Wouldn’t Want To Lose My Mammograms,’ Male GOP Senator Says — Then Immediately Regrets
It’s a common question among those decrying the cost of health insurance: Why should you have to purchase a plan that covers procedures you won’t ever need? Especially if, say, you’re a guy, and your plan covers maternity care — as Obamacare requires most plans sold through an exchange to do? It’s also a philosophy in conservative circles gaining momentum as Republicans try to deconstruct Obamacare, (Phillips, 3/23)
Bloomberg:
Pharma Gets Roped Into The Trumpcare Maelstrom
As President Donald Trump and congressional Republicans scramble to save their troubled attempt to repeal and replace the Affordable Care Act, they are considering last-second changes -- including one that could add Big Pharma to the list of those damaged by the bill. This would further immiserate an industry already dogged by the president's repeated drug-pricing broadsides. To win conservative support, the White House has reportedly offered to repeal the ACA's requirement that insurers cover a list of what it calls essential health benefits, including hospitalization, maternity -- and prescription drugs. (Nisen, 3/23)
