ESSENTIAL HEALTH BENEFITS PACKAGES

Essential Health Benefits Packages

Table of Contents

Introduction2

Discussion and Analysis2

Excluding services from EHB packages and it's affect on ACA's anti-discrimination policies:3

Balancing costs and ensuring that some patients are not discriminated against:4

Conclusion5

References6

Essential Health Benefits Packages

Introduction

The ACA (Affordable Care Act), which includes the Patient Protection Act obligates that starting from the 1st January, 2014, majority of the plans of individual and small group health insurance provide a detailed package of covered services and items referred to as EHB package (Essential Health Benefit). This condition concerns the plans offered both outside and inside a state or federal exchange of insurance. The plans that got established before the Affordable Care Act's passage on 23rd March, 2012 that have not come up with significant alterations to service that are covered are known as the grandfathered plans. The Essential Health Benefit's intent is assuring small businesses and consumers that at the time of a health plan purchase, they could be sure that the plan would cover a detailed health services set.

In the month of December of the year 2011, a Bulletin was issues by the HHS (Department of Health and Human Services) that signaled its intention of allowing states in determining independently the benchmark set for EHB for each plan that was sold within their state. Although, each state is necessary to take decision on Essential Health Benefits by the year 2012's third quarter, and the Department of Health and Human Services has declared that they do “intend to pursue………. EHB in the future”, as per this brief's publication the ultimate regulations have not been published. This paper mentions the services, which can be excluded from Essential Health Benefits packages and how will this exclusion affect the anti-discrimination policies Affordable Care Act. Furthermore, the paper explains the protections that consumers seek in reference to Essential Health Benefits, and the interest of different stakeholders. In addition to this the paper explains whether the Essential Health Benefits be standard nationally, or individualized by state, and assesses whether the most recent proposed regulations for Essential Health Benefits are helpful or not. Lastly, the paper describes the ways of balancing costs and the ways of ensuring that some patients are not discriminated against.

Discussion and Analysis

All states have a considerable number of laws, which necessitate the private market insurers of health for covering the provider services and specific benefits. The ACA (Affordable Care Act) provides for EHBs, described as health services and treatment and the rights for using provider services that are specialized; as explained in the present state laws (2010-11) these classification sum up to around 1,600 to 1,800.

Considerable alterations could be anticipated for a number of U.S. citizens in terms of EHBs plans, which would be provided at the time each state begins to implement the exchanges of public healthcare mandated by the ACA in less than a couple of years. These alterations are other than the adjustments of benefit plan, which previously was in-effect for existing and new coverages of insurance over last ...