Biden Urged to Revamp Essential ACA Benefits
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The number of people covered by the Affordable Care Act (ACA) health coverage is increasing but many cannot access necessary care, according to Adam Fox, deputy director of the Colorado Consumer Health Initiative. Fox has called on the Biden Administration to update the ACA’s Essential Health Benefits, which are services required to be covered by most individual and small-employer insurance plans. While some insurers warn that expanding essential benefits will increase insurance premiums and healthcare costs, Fox believes it will lower costs and improve health coverage quality.
Affordable Care Act Health Coverage Rise: Access to Care Remains Limited
The populace under the Affordable Care Act’s (ACA) health coverage is increasing. However, many struggle to receive the care necessary for their wellbeing.
Adam Fox, Colorado Consumer Health Initiative’s deputy director, insists that the Biden Administration can address this issue by revising the ACA’s Essential Health Benefits.
These represent an array of vital services that most individual and small-employer insurance plans should cover.
“Every American should have access to these fundamental services. The package should incorporate dental coverage for adults, a full spectrum of reproductive health services, and perinatal and postpartum care for those giving birth. Hearing and vision benefits should also be included,” Fox stated.
Colorado has already made strides in expanding benefits to cater to various health care needs, incorporating gender-affirming care and coverage for all individuals regardless of immigration status.
ACA coverage providers have warned that broadening essential benefits could escalate health care costs and insurance premiums. However, Fox opines that updating essential benefits would effectively lower costs and enhance health coverage quality for all.
This includes individuals insured through ACA marketplaces like HealthCare.gov, those with employer-sponsored plans, or enrollees in programs like Medicaid.
“Many proactive and preventative care services help people maintain their health and avert more expensive health interventions. As such, they are likely to save costs,” Fox added.
It’s been over 13 years since the ACA initiated rules outlining ten health service categories that most insurance policies should cover. Nonetheless, numerous states have not done anything to update or expand these benefits.
“We need federal action to update essential health benefits, ensure full-range whole person care coverage, and make this a nationwide requirement,” Fox concluded.
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