The Patient Protection and Affordable Care Act requires the Department of Health and Human Services to mandate that health plans offer “essential health benefits.” On Dec. 16, 2011, HHS proposed letting each state choose an existing health plan operating in the state to act as a benchmark for minimum coverage. States can choose benchmark plans from among four types of popular health insurance products.
However, the potential benchmark plans include some that do not cover rehabilitative and habilitative treatment for children. The American Medical Association wrote that essential health benefits standards should include all preventive, diagnostic and treatment services that are medically necessary for children.
The AMA also wrote that HHS’ proposed prescription drug coverage minimum is insufficient. HHS currently requires health plans to cover only one prescription medication per drug class.
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