What are "essential health benefits" as defined by the ACA?

Essential health benefits, as defined by the Affordable Care Act (ACA), refer to the minimum set of services that must be included in all qualified health plans. This includes a broad range of categories such as emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive and wellness services, and pediatric services.

The requirement for essential health benefits ensures that insurance plans provide comprehensive coverage that meets the basic healthcare needs of individuals and families. This was a significant change in the health insurance landscape, aimed at increasing access to necessary medical care and preventing the discrimination found in many prior insurance practices that excluded critical services.

Options that suggest services are optional or specifically targeted at high-risk individuals do not align with the ACA's intention, which mandates these benefits must be universally included in plans to ensure broad access to crucial health services.