What are the Obamacare essential benefits?

White House: We're done negotiating on health care bill

In a last-minute effort to win Republican votes, GOP leaders told conservatives they would repeal the essential health benefits former President Barack Obama’s health overhaul requires insurers to cover. 

It’s a tricky proposition for Republican lawmakers, because Democrats are certain to challenge any such move as out-of-bounds under special budget rules that would allow the GOP health bill to clear the Senate with just 51 votes. Until now, the ACA’s benefit requirement had not been considered a budgetary issue.

Traditionally, states have regulated the benefits that health insurers offering plans to individual consumers must provide. But the Obama-era health care law set a minimum floor for the whole nation. To comply with the ACA, every health insurance plan sold on the exchanges or provided by employers had to include these benefits -- here’s the the list of the 10 essential benefits, as defined by the ACA:

  1. Outpatient care
  2. Emergency room visits
  3. Hospital treatment for inpatient care
  4. Prenatal and postnatal care -- that is, maternity care preceding and after birth of baby 
  5. Mental health and substance use disorder services, including behavioral health treatment, counseling, and psychotherapy
  6.  Prescription drugs
  7. Services and devices to aid in recovery in case of injury, disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Lab tests
  9. Preventive services, including counseling, screenings, and vaccinations and care for managing chronic disease.
  10. Pediatric services, including dental and vision for children 

The House is expected to vote on the Republican plan to replace the Affordable Care Act Friday morning.

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