The recently upheld Patient Protection and Affordable Care Act calls for each state to develop a health insurance exchange to make it easier for employers and residents to compare and purchase health insurance coverage. Each state must determine if it wants to work with the federal government or independently in deploying the web-based shopping portal, and they must also define what essential benefits must be covered by all policies sold through the exchange.
Connecticut News Junkie reported the state’s Insurance Exchange Board approved a list of essential health benefits last week that will require a number of services to be covered by all participating health insurance providers. In all states, health plans must cover emergency services, mental health services, hospitalization, prescription drugs, pediatric services, maternity care and rehabilitation services. More specific coverage details will be left to each state’s lawmakers and industry experts.
When determining essential benefits for the exchange, Ben Barnes, secretary of the Office of Policy and Management, told the source many factors have to be considered. While lawmakers want to ensure as many benefits are covered as possible, cost is also a significant factor, as many employers are considering dropping health insurance coverage altogether to improve the bottom line.
According to Kaiser Health News, many states have established their essential benefits while others are still dragging their feet. California and Washington, for example, have included acupuncture as a must-cover benefit, while Arkansas will offer plans that enable residents to seek prevention counseling for women who have a high risk of developing breast cancer. Arkansas will not, however, cover expensive infertility treatments that have gained popularity in the last few years.