Just one out of every 50 health plans in the private insurance market currently meets the minimum coverage or essential health benefit standards that will be required in 2014 under the Affordable Care Act. Most of the 11,000 plans analyzed covered physician visits, emergency department care, hospitalization and laboratory testing. However, plans lacked coverage in others areas that will be required by the ACA, such as:
- Pediatric care, covered by only 25 percent of plans;
- Dental checkups for children, covered by 8 percent;
- Maternity and newborn care, covered by about 33 percent; and
- Substance use disorder treatment, covered by slightly more than 50 percent of plans.
States with plans covering the most of the ACA’s essential benefits were Massachusetts (an average of 94 percent of essential benefits covered); Rhode Island (93%); Hawaii, (90%); California (89%); Maryland (89%); and Vermont (89%).
The states with plans covering the fewest essential benefits were Alaska (an average of 66% included); Wisconsin (67%); Texas (68%); and New Hampshire (68%).