Last updated on: 10/24/2012 9:02:33 AM PST
Does Obamacare Require Insurance Plans to Have a Minimum Basic Coverage Level? – YES
General Reference (not clearly pro or con)
The Patient Protection and Affordable Care Act, Section 1302, "Essential Health Benefits Requirements," page 45, signed into law on Mar. 23, 2010, available at the Library of Congress website, states:
"(b) ESSENTIAL HEALTH BENEFITS.—
(1) IN GENERAL.—Subject to paragraph (2), the Secretary shall define the essential health benefits, except that such benefits shall include at least the following general categories and the items and services covered within the categories:
(A) Ambulatory patient services.
(B) Emergency services.
(D) Maternity and newborn care.
(E) Mental health and substance use disorder services, including behavioral health treatment.
(F) Prescription drugs.
(G) Rehabilitative and habilitative services and devices.
(H) Laboratory services.
(I) Preventive and wellness services and chronic disease management.
(J) Pediatric services, including oral and vision care."
Mar. 23, 2010 - Patient Protection and Affordable Care Act (HR 3590) (2MB)
The Congressional Research Service (CRS) stated the following in its Apr. 15, 2010 report "Private Health Insurance Provisions in PPACA," available at Senator Jeff Bingaman's website:
"PPACA... sets minimum standards for health coverage...
These standards will affect private health insurance in the individual, small group, and large group markets, depending on the standard... and require coverage for specified categories of benefits...
The Secretary will specify the 'essential health benefits' included in the 'essential health benefits package' that QHPs will be required to cover (effective beginning in 2014). Essential health benefits will include at least the following general categories:
- ambulatory patient services;
- emergency services;
- maternity and newborn care;
- mental health and substance use disorder services, including behavioral health treatment;
- prescription drugs;
- rehabilitative and habilitative services and devices;
- laboratory services;
- preventive and wellness and chronic disease management; and
- pediatric services, including oral and vision care.
Coverage provided for the essential health benefits package will provide bronze, silver, gold, or platinum level of coverage...
A health plan will be allowed to provide benefits in excess of the essential health benefits defined by the Secretary."
[Editor's Note: Based upon a neutral reading of the Patient Protection and Affordable Care Act and bi-partisan third party analysis, this question seems to have a clear and obvious Pro (yes) answer, and ProCon.org has therefore presented the responses in a single column with no opposing perspective.]