AHA responds to CMS on potential modifications to ACA’s Essential Health Benefits

The AHA July 15 responded to a request for information from the Centers for Medicare & Medicaid Services on the Affordable Care Act's Essential Health Benefits framework, which creates the guardrails for defining comprehensive insurance coverage. The AHA supported updating the EHBs to reflect a changing healthcare landscape but cautioned CMS against changes to the EHBs that would dilute coverage, noting that affordability cannot be measured by premiums alone and that adequate coverage is essential for true affordability.

"As CMS undertakes this review, we urge the agency to approach any potential future policy changes with the understanding that affordability cannot be achieved by making coverage less adequate," the AHA wrote. "Lower premiums are not the same as lower healthcare costs for patients, if they are accompanied by reduced benefits, narrower coverage standards, higher deductibles, greater cost sharing or other changes that increase households' financial exposure when care is needed."