Why We Need “Essential Health Benefits” on Every Health Insurance Plan
My wife and I were in San Francisco last week, and we caught a Lyft ride to have dinner with friends. As we rode, the driver started chatting with us. He asked us what we were doing there, and we told him we were there for a conference on mental health counseling. He then told us that he was glad for people working on mental health issues because of his wife.
The driver told us that his wife is on disability because she is having issues with post-traumatic stress disorder (PTSD). She was a paramedic, and she got called out to help search for a missing baby. The baby’s mother showed up to a hospital having given birth, but she didn’t have the baby with her. So the wife of the driver and cops and other paramedics set out to find the baby. The wife was the one who found the baby dead in a trashcan.
She developed PTSD because of this experience as she and her husband had been trying to get pregnant for a while.
One of the essential health benefits under the Affordable Care Act (aka Obamacare, aka ACA) is mental health services. That is, every health insurance policy must cover mental health services in one way or another. Without this mandate, insurance policies can sell you very cheap plans that leave you out in the cold for things like sudden onset PTSD. After all, I don’t think the wife of the driver was planning on getting PTSD that morning.
The US Representative from my district, Scott Perry, continues to mock the essential health benefits as unneeded mandates that raise the price of health insurance. He often wonders on social media and in interviews why a policy must include things that people, in his opinion, don’t need. Often, he and others in the so-called “Freedom Caucus” (because freedom is only theirs, I guess?) mock maternity and newborn care in policies for older adults. What they fail to tell you is that these mandates make it opt-out instead of opt-in for these services, and that older adults in the United States more often than not will be covered under Medicare and a Medicare benefit extension.
That’s the kind of dishonesty we’ve been seeing in the last few weeks. Luckily, the repeal of the ACA failed for the time being. The Republicans in Congress are starting to realize that they’re not one party anymore. They’re two parties under the same name, and that they both are going to have a hard time dealing with a President who is from a third, very weird, white supremacist, populist, protectionist, nationalist party.
We’ll see how the fight continues, but don’t be fooled for a minute that mental health services coverage is not essential in your health insurance. It is. None of us ever planned to get PTSD, and we did.