Essential Health Benefits: 50-State Variations on a Theme

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All qualified health plans under the ACA must cover a package of essential health benefits (EHBs) equal in scope to a typical employer plan. The law laid out 10 general categories of services that EHBs must cover, but did not itemize those services. As an interim policy for 2014 and 2015, the Department of Health and Human Services allowed each state to identify an existing plan as a benchmark for these EHBs. The result of this policy is that EHBs vary from state to state, often because of a legacy of different state-mandated benefits (such as treatments for autism, infertility, or temporomandibular joint disorders). This brief analyzes state variation in coverage and limits for these non-uniform benefits.

Resource Details

Date: Nov 2014
Author: University of Pennsylvania and RWJF