Some policymakers have proposed allowing states to use waivers to reduce or eliminate essential health benefit requirements.

Patients would face thousands of dollars in new out-of-pocket expenses if states were allowed to waive an Affordable Care Act provision that requires insurance companies to cover 10 essential health benefits. This was one of the key findings of a recent analysis by the Urban Institute funded by the Robert Woods Johnson Foundation.

The requirement that these benefits be included in ACA-compliant nongroup insurance coverage increases premiums beyond what they would be if people could purchase plans covering fewer benefits. This had made the requirements somewhat controversial and spurred interest in reducing or eliminating them among some insurers and policymakers. Some have proposed allowing states to use waivers to reduce or eliminate essential health benefit requirements.

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