Essential Health Benefits Discussed This Week In Chicago

This week a public meeting will be held in Chicago to determine which Essential Health Benefits (EHB) Illinois will cover in future health insurance plans. The Affordable Care Act has tasked each state with creating a set of EHB, which are a comprehensive package of health benefits.

Beginning in 2014, all health plans are required to begin offering the EHB to beneficiaries in the individual and small group markets. These state-based benchmark decisions are due by September 30, 2012, and could eventually affect nearly 70 million Americans, many of whom are women. The law mandates that 10 basic categories must be covered. These inlcude:

1. Ambulatory Patient Services

2. Emergency Services

3. Hospitalization

4. Maternity and Newborn Care

5. Mental Health and Substance Use Disorder Services

6. Prescription Drugs

7. Rehabilitive and Habilitive Services

8. Laboratory Services

9. Preventative and Wellness Services and Chronic Disease Management

10. Pediatric Services

Governor Pat Quinn will choose a benchmark plan that will then serve as the mandatory minimum for insurance plans in the state. The greatest importance of these EHB decisions will be the amount of coverage required in each category and the costs of insurance due to those new requirements. At first glance, it might seem the package of services related to maternity and new born care will have the most impact on women, however, it is likely that the mental health and substance use disorders services may be most needed given that women are far more likely to suffer from a wide range of anxiety disorders and depression. Despite enthusiasm for more even coverage and plan equality, the minimum categories will require that almost all insurance plans offer more than they do at present, certainly impacting the cost of health insurance.