Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has announced a final rule that will make purchasing health coverage easier for consumers. The policies outlined will give consumers a consistent way to compare and enroll in health coverage in the individual and small group markets, while giving states and insurers more flexibility and freedom to implement the Affordable Care Act (ACA), she said.
“The Affordable Care Act helps people get the health insurance they need,” said the secretary. “People all across the country will soon find it easier to compare and enroll in health plans with better coverage, greater quality and new benefits.”
The rule outlines health insurance issuer standards for a core package of benefits, called essential health benefits, that health insurance issuers must cover both inside and outside the Health Insurance Marketplace (state exchange). Through its standards for essential health benefits, the final rule released also expands coverage of mental health and substance use disorder services, including behavioral health treatment, for millions of Americans.
In the past, nearly 20 percent of individuals purchasing insurance didn’t have access to mental health services, and nearly one third had no coverage for substance use disorder services. The rule seeks to fix that gap in coverage by expanding coverage of these benefits in three distinct ways:
- By including mental health and substance use disorder benefits as Essential Health Benefits
- By applying federal parity protections to mental health and substance use disorder benefits in the individual and small group markets
- By providing more Americans with access to quality health care that includes coverage for mental health and substance use disorder services.