Skip to main content

Advanced Search

Advanced Search

Current Filters

Filter your query

Publication Types

Other

to

Issue Briefs

/

Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements

kids health care
Toplines
Toplines
Downloads

Overview

The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as “essential health benefits.” Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees’ experiences with their coverage—information called for under the law’s delayed transparency requirements—to determine whether states’ differing strategies are producing the coverage improvements promised by reform.

Publication Details

Date

Contact

Justin Giovannelli, Associate Research Professor, Center on Health Insurance Reforms, Health Policy Institute, McCourt School of Public Policy, Georgetown University

[email protected]

Citation

J. Giovannelli, K. W. Lucia, and S. Corlette, Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements, The Commonwealth Fund, October 2014.