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HomeFocus → Health Law's 10 Essential Benefits: A Look At What's At Risk in GOP Overhaul

Health Law's 10 Essential Benefits: A Look At What's At Risk in GOP Overhaul Print E-mail
Written by Michelle Andrews | KHN   
Thursday, 23 February 2017 00:00

khn logo black As Republicans look at ways to replace or repair the health law, many suggest shrinking the list of services insurers are required to offer in individual and small group plans would reduce costs and increase flexibility. That option came to the forefront last week when Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.

Maternity coverage is a popular target and one often mentioned by health law critics, but other items also could be watered down or eliminated.

There are some big hurdles, however. The health law requires that insurers who sell policies for individuals and small businesses cover at a minimum 10 "essential health benefits," including hospitalization, prescription drugs and emergency care, in addition to maternity services. The law also requires that the scope of the services offered be equal to those typically provided in employer coverage.

"It has to look like a typical employer plan, and those are still pretty generous," said Timothy Jost, an emeritus professor at Washington and Lee University Law School in Virginia who is an expert on the health law.

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