Removing Maternity Care and Mental Health Treatment from Coverage Requirements Would Reduce Premiums, but Lead to Significant Spending Increases for Some Consumers


May 18, 2017

New mother resting in maternity room after childbirth

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This commentary originally appeared on The Commonwealth Fund Blog on May 18, 2017.

The Affordable Care Act (ACA) required most individual and small-group health insurers to cover 10 “essential health benefits,” including outpatient services such as office visits, hospitalization, emergency department visits, prescription drugs, and other specific types of care. By requiring insurance coverage for these services, the ACA ensures that everyone who enrolls in insurance receives a standard benefit package that covers, at a minimum, commonly used services. However, the requirement may raise insurance premiums relative to what would be expected if coverage of these services were not required. The American Health Care Act recently passed by the U.S. House of Representatives to repeal and replace the ACA allows states to waive such benefits....

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Christine Eibner is a senior economist and Christopher Whaley is an associate policy researcher at the nonprofit, nonpartisan RAND Corporation.