Caps on Health Insurance

Before passage of Obamacare, many Americans were subject to annual and/or lifetime caps on the amount of money their insurer would pay for their coverage; for example, if your insurance plan had a lifetime cap of a million dollars, the insurance company would stop paying your bills once they reached a million dollars.

Between 2010and 2016, bankruptcies decreased by 50 percent. One of the reasons sighted for the decrease in bankruptcies is the elimination of annual and lifetime caps on health insurance.

Under Obamacare, there is a ban on annual and lifetime caps; however, the ban is tied to the 10 essential health care benefits (EHBs).

The Senate’s health care bill allows states to get waivers in order to define coverage levels in their states. Those waivers will be used to reduce if not eliminate the number of EHBs that must be offered in some states. Since the annual and lifetime caps are tied to the EHBs, a waiver from those requirements would allow health insurance companies to reinstitute annual and lifetime caps.

The Senate’s bill also allows large employers to buy health insurance in any state where they do business. This means that you could live in a state that still requires health insurance providers to cover the EHBs and still not have access to those protections.

The Senate’s bill also says that someone with access to any employer-sponsored health insurance doesn’t qualify for a tax credit to help pay for health insurance. If your employer refuses to cover maternity care, contraception, pediatric dental services, mental health, or anything else you want–the government won’t help you buy private insurance.


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