Does The New AHCA Get Rid Of Essential Health Benefits? It's Complicated
After the first draft of the American Health Care Act failed to make it to the floor to be voted on by legislators, people collectively rejoiced — they would get to keep their current health care plans and benefits from the Affordable Care Act. Now, a new version of the AHCA is set to be voted on Thursday — making those same people understandably very worried once more. More specifically, this new draft, which would repeal and replace Obamacare if passed, has people wondering if the new AHCA get rid of essential health benefits altogether.
A quick recap — essential health benefits are things that a majority of people with insurance definitely don't want to get rid of. Under the ACA, insurance suppliers must cover the following 10 essential health benefits: ambulatory patient services, emergency services, hospitalization, pregnancy and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative services, laboratory services, preventative and wellness services, and pediatric services. All of these 10 essential benefits seem like things that should be covered under insurance policies automatically — except lawmakers were pushing to get rid of essential health care benefits completely in the original draft of the AHCA before the legislation was killed late March.
Essential health benefits don't seem to be leaving the new AHCA for now, but keeping them in does come at a cost. Instead, essential health care benefits will be left up to the states — which could then waive out of providing certain benefits.
According to CNN, while this might appear to be good news, new AHCA negotiations will also allow for a lot of negative things such as allowing for insurance companies to charge higher premiums to those who are in their 50's or 60's and curtail federal support for Medicaid.
So what this mean for the states? This amendment to the new AHCA proposed that states would be able to opt out of essential health benefits and get a waiver on them, according to FiveThirtyEight. This, in turn, would reduce average insurance premiums in the state, but won't benefit policy holders. Policy holders wouldn't be guaranteed the essential health benefits, insurers would be able to offer "skimpier policies", and those who are sick or unable to afford costly services that insurance companies were once required to cover will ultimately lose out.
While the new AHCA won't get rid of essential health benefits, it's unclear whether or not insurance companies will want to keep them, either. One thing is for certain — depending on where you live or your insurance provider, your essential health benefits could definitely be at stake.