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.

4 Comments on “Why We Need “Essential Health Benefits” on Every Health Insurance Plan”

  1. This entire episode was a major debacle for the GOP. Lines that were shaky alliances between the hard right tea party types and the mainstream majority of the party have been fractured and widened with each bit of push that Trump and both houses of Congress majority leadership exerted, as the mainstream realized what the far right types haven’t yet realized – that the effort itself is political suicide.
    During the debate, I corresponded with my die hard tea party senators and representatives, with zero traction being gained. I replied a reminder that their behavior towards their constituents concerns, their disparaging of those concerns and condescending attitude, as well as their dismissal of those concerns will be remembered on election day, when even a potted plant would be capable of defeating them.
    Respectful replies, which were negative received a more polite, similar content reply, condescending and insulting replies received rather gentlemanly versions of the potted plant notion.
    Fortunately, none chose to abuse the police system, as other tea party types have, wasting the time of both constituent and law enforcement, to much bad press for said politician.
    So, it’s obvious that these people can learn, they just choose to learn as little as possible. Something odd, as one is a physician, who feels that health care is something optional.

    Oh well, if we ever bump into one another, I do indeed intend to trip him with my cane. Twice.


    • My congressman (or his lackeys) keep intermittently blocking me from Facebook. His motto during elections is “Scott Perry: Husband, Father, Leader.” I don’t know how his home life is, but he sure ain’t no leader. I subscribe to the “conservative” blogs and newsletters and he inevitably parrots their talking points each day. I am very skeptical that he has had an original thought as a politician. A lot of people are mad at him, and he even went as far as saying that we don’t need the EPA since, according to him, God creates pollution, so how much can a government agency regulate God.

      I wish I was joking.


      • I honestly think that they want to repeat the mistakes like those that lead to children dying of cancer at Love Canal.
        Their claiming that God creates pollution, so we shouldn’t regulate our own pollution is like saying that it was God’s will, after picking up a gun and shooting a child with it.
        Either that idiot thinks that he is God or his view of God makes Islamist militants look good.


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