What Are ‘Essential Benefits’ in GOP Health Care Bill Debate? – NBCNews.com

Obamacare's 10 essential health benefits cover basic services such as vaccines and pediatric visits Joe Raedle / Getty Images, file

Here's a rundown of what they are:

Most Americans get their health insurance through an employer, and most employer-sponsored plans offer most of these benefits as a matter of course. Fewer than 10 percent of Americans buy health insurance on the individual market and that's the market covered by the ACA's essential benefits.

Pre-Obamacare, insurance companies could offer very cheap policies that either did not cover many conditions, or that charged a very high deductible or co-pay for such claims.

Advocates for keeping in the essential health benefits clause say it's the only way to make health insurance manageable and fair.

"Health insurance is confusing enough as is,"

"Rolling back benefit standards and allowing insurers to make coverage decisions would add to that confusion. And it would put millions of Americans at risk for having a health insurance card but remaining under-insured."

House Speaker Paul Ryan said it's about choice. "Instead of imposing arrogant and paternalistic mandates, it would increase choice and competition, creating a vibrant market where every American will have access to quality, affordable coverage," he

There's another stumbling block to removing the essential benefits. Thursday's vote on the AHCA comes under congressional rules that say any bill must affect the budget. So any changes to the essential benefits requirements will have to lower federal spending somehow.

But Larry Levitt of the nonpartisan Kaiser Family Foundation said that's unlikely. "It's almost certainly the case that repealing benefit requirements would raise the cost of the AHCA since more people would use tax credits," he tweeted.

Go here to see the original:
What Are 'Essential Benefits' in GOP Health Care Bill Debate? - NBCNews.com