The Issue
This study illustrates that outside of the 10 ACA-mandated service categories, where patients live determines whether they’ll have coverage for the care they need.
The majority of data used in this study was collected from the CMS Revised Benchmark Benefits Worksheet published May 22, 2014. This data set contained a collection of state-specific worksheets detailing essential health benefits, state required benefits, quantitative limits on benefits and other general coverage information for all 50 states and the District of Columbia.
25 states require plans to cover nutrition counseling
26 states require coverage of services to treat autism
45 states require coverage of chiropractic care
But only 5 require coverage for weight loss programs
Conclusion
The government will reassess whether or not to set a national benchmark EHB plan in 2016, but until then, the range and scope of services included in the EHBs will vary greatly from state to state.
The Leonard Davis Institute of Health Economics (LDI) is the University of Pennsylvania’s center for research, policy analysis, and education on the medical, economic, and social issues that influence how health care is organized, financed, managed, and delivered.