On January 31, 2023, the National Women’s Law Center submitted a comment in response to a Request for Information about Essential Health Benefits (EHBs). Established under the Affordable Care Act, EHBs are broad categories of health care services that must be covered in Marketplace plans, such as pregnancy and postpartum care, prescription drugs, and mental health services. Before the ACA, many insurance plans excluded these basic services, disproportionately harming women, people of color, disabled people, and LGBTQI+ people. EHB requirements have been instrumental in reversing these exclusions and reducing disparities in access to care. But despite this progress, there remains a great deal of variation in EHB coverage across the country, with many states continuing to exclude critical services and relying on standards that are inadequate to meet the needs of underserved communities. 

In our comment, we urged the Department of Health and Human Services to adopt a number of measures to strengthen EHBs. We recommended that it develop a robust federal definition for each EHB categories, providing states with minimum standards for coverage. We also urged it to reduce disparities in access to key EHB categories, including disparities related to gender, race, disability, and LGBTQI+ status. And we outlined a range of additional policies that would strengthen EHB coverage, including limiting utilization controls, mandating detailed benefit descriptions in benchmark plans, clarifying requirements related to defrayal and generosity limits, and establishing regular EHB reviews. 

Our full comment can be found here.