Print Friendly and PDFPrinter Friendly Version

Blog
Wednesday, November 16, 2011

Speak up at a listening session on health insurance coverage!

The Department of Health and Human Services (HHS) is holding 10 regional listening sessions throughout the country about what benefits health plans should be required to cover as part of an “essential benefits package” under the  health care law. The first listening session was in Chicago last Friday, and the last session will be held in San Francisco on Monday, November 21. The listening sessions are open to the public, but you must RSVP. For a list of listening session locations and dates, click here.

In 2014, the Affordable Care Act will require that all new plans sold in the individual and small group markets and in the new health insurance exchanges, as well as Medicaid benchmark plans cover an essential health benefits (EHB) package. The EHB package establishes a coverage floor—making covered benefits comprehensive and standardized across plans. The Affordable Care Act specifically states that the essential health benefits package must include at least the 10 categories of benefits listed below:

  • ambulatory patient services
  • emergency services
  • hospitalization
  • maternity and newborn care
  • mental health and substance use disorder services
  • prescription drugs
  • rehabilitative and habiliative services and devices
  • laboratory services
  • preventive and wellness services and chronic disease management
  • pediatric services, including oral and vision care

In 2010, 29 million Americans under age 65 were underinsured. This means that their health care plans might not cover needed treatments or might come with high out-of-pocket costs, which makes care unaffordable for them even though they have insurance. Thanks to the Affordable Care Act, uninsured and underinsured adults and children will have access to affordable coverage. The essential health benefits package is meant to ensure that this coverage is also comprehensive, covering the services that people need to become and stay healthy.

It is important for consumers and consumer advocates to make their voices heard on this issue by attending the HHS listening sessions and submitting their comments to HHS. The essential health benefits package must be comprehensive so that consumers can get the care they need when they need it. No one should have to forgo a needed medical treatment or prescription because his or her health plan does not cover it or makes it prohibitively expensive.