Today the U.S. Department of Health and Human Services, the federal agencies charged with implementing the Affordable Care Act, released final rules on Essential Health Benefits standards, which will benefit millions of Americans who will have increased access to comprehensive insurance coverage.
Starting in 2014, small group and individual market health insurance plans – including plans sold inside and outside of Health Insurance Marketplaces — will be required to cover items and services in 10 “Essential Health Benefit” categories. These categories include vital services needed by many gay and transgender people, including prescription drugs, hospital stays, and mental and behavioral health services.
Standards for Essential Health Benefits will benefit everyone who buys small group or individual insurance plans by guaranteeing a comprehensive level of coverage. In addition, the rules provide key protections for gay and transgender people through the unprecedented protections against discrimination in benefits coverage, including on the basis of sexual orientation, gender identity, and health condition. This means that insurance companies cannot use limitations or exclusions for benefits that discriminate against gay and transgender patients — potentially ending a long history of discrimination by insurers.
The federal rules will provide much-needed guidance to state policymakers, who are working quickly to establish Essential Health Benefits standards that will apply to insurers next year. These rules, and the protections they give to gay and transgender individuals and their families, are key in achieving the law’s goal of making affordable, comprehensive health care coverage available to all Americans.
Our guest blogger is Andrew Cray, a research associate for LGBT Progress at the Center for American Progress.