HEALTH CARE
mandates staying put.
The failure of Republicans to replace the Affordable Care Act means insurers will continue to cover 10 federally required minimum benefits for consumers, at least for now.
“I don’t think anything is going to change there” regarding essential health benefits, state Sen. David Sanders, R-Little Rock, said Friday. Sanders is chairman of the Arkansas Health Insurance Marketplace Legislative Oversight Committee.
In last-minute efforts to gain support from conservative lawmakers, President Donald Trump agreed to eliminate a federal requirement, now part of the Affordable Care Act, that insurers cover 10 “Essential Health Benefits.”
Those include certain outpatient and in-hospital care, mental-health and substance-abuse services, lab tests, pediatric services and more.
But Republican leaders removed the American Health Care Act replacement plan from consideration before the U.S. House of Representatives on Friday, saying they didn’t have enough votes to pass it.
That leaves intact the Affordable Care Act, also known as Obamacare, along with its essential health benefits.
All of Arkansas’ private-op-
tion health insurance plans — bronze, silver and gold levels — meet the 10 federal requirements, according to Alicia McCoy, a spokesman for Arkansas Health Insurance Marketplace.
The agency manages the state’s health insurance exchange program.
States can demand more than the federal insurance requirements, and Arkansas is among states that do, Sanders said.
“We’re not quite New York state, but Arkansas goes far and above what other states do as far as mandated benefits,” he said.
In-vitro fertilization and craniofacial surgery to correct a cleft palate are among medical services insurers are required to cover in Arkansas, he said.
“Arkansas has some big decisions to make moving forward about insurance,” Sanders said. “I don’t think many people know they pay for in-vitro fertilization.”
The required federal benefits had been popular with many consumers who bought insurance outside the workplace, studies show. Before the Affordable Care Act, those policies often didn’t include maternity care, substance abuse treatment and mental health services or prescription drug coverage.
The Freedom Caucus of U.S. House members favored eliminating the essential health benefits provision to cut costs.
Caucus members also said consumers should pay only for health coverage they need. A 70-year-old woman, for example, shouldn’t have to pay for an insurance policy that covers maternity care.
These are among state-required insurance benefits in Arkansas, according to the federal Center for Consumer Information & Insurance Oversight: out-of-area emergency room services; minimum hospital stay with childbirth; mastectomy hospital stays; diagnosis and treatment of autism disorders; orthotic or prosthetic devices; colorectal screening; contraceptives, if drug benefit is offered; prosthetic devices; nutritional counseling for diabetes; breast reconstruction/ mastectomy; off-label drug use; dental general anesthesia under certain circumstances; gastric pacemakers; children’s preventative health care; loss or impairment of speech or hearing.