Rosenbaum Sara, Teitelbaum Joel, Hayes Katherine
George Washington University School of Public Health and Health Services, USA.
Issue Brief (Commonw Fund). 2011 Mar;3:1-16.
In establishing minimum coverage standards for health insurance plans, the Affordable Care Act includes an "essential health benefits" statute that directs the U.S. Secretary of Health and Human Services not to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life. This issue brief examines how this statute will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need. The authors also discuss the complex issues involved in implementing the essential benefits provision and offer recommendations to federal policymakers for ensuring that people with disabilities receive the full insurance benefits to which they are entitled.
在制定医疗保险计划的最低覆盖标准时，《平价医疗法案》包含一项“基本健康福利”法规，该法规指示美国卫生与公众服务部部长不得因年龄、残疾或预期寿命而歧视个人，从而做出承保决定、确定报销费率、设立激励计划或设计福利。本问题简报探讨了该法规将如何帮助残疾美国人，他们目前因健康状况和医疗需求而受到保险公司的歧视。作者还讨论了实施基本福利条款所涉及的复杂问题，并向联邦政策制定者提出建议，以确保残疾人获得他们应得的全部保险福利。
