What are the Obamacare essential benefits?
In a last-minute effort to win Republican votes, GOP leaders told conservatives they would repeal the essential health benefits former President Barack Obama’s health overhaul requires insurers to cover.
It’s a tricky proposition for Republican lawmakers, because Democrats are certain to challenge any such move as out-of-bounds under special budget rules that would allow the GOP health bill to clear the Senate with just 51 votes. Until now, the ACA’s benefit requirement had not been considered a budgetary issue.
Traditionally, states have regulated the benefits that health insurers offering plans to individual consumers must provide. But the Obama-era health care law set a minimum floor for the whole nation. To comply with the ACA, every health insurance plan sold on the exchanges or provided by employers had to include these benefits -- here’s the the list of the 10 essential benefits, as defined by the ACA:
- Outpatient care
- Emergency room visits
- Hospital treatment for inpatient care
- Prenatal and postnatal care -- that is, maternity care preceding and after birth of baby
- Mental health and substance use disorder services, including behavioral health treatment, counseling, and psychotherapy
- Prescription drugs
- Services and devices to aid in recovery in case of injury, disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
- Lab tests
- Preventive services, including counseling, screenings, and vaccinations and care for managing chronic disease.
- Pediatric services, including dental and vision for children
The House is expected to vote on the Republican plan to replace the Affordable Care Act Friday morning.
