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Cost must be considered in setting essential health benefits under US health reform act

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6524 (Published 10 October 2011) Cite this as: BMJ 2011;343:d6524
  1. Janice Hopkins Tanne
  1. 1New York

A report from the US Institute of Medicine says cost must be considered in determining a package of “essential health benefits” to be provided under the US health reform act (the Patient Protection and Affordable Care Act). The report does not list the specific benefits to be covered.

The health reform act will reduce the number of uninsured and under-insured individuals, said Harvey Fineberg, president of the Institute, in a foreword to the report. “The lack of health insurance is harmful to health, and equity in access to needed healthcare is one measure of a just society. But . . . how should one go about deciding what to include as essential in a health insurance plan? . . . This report lays …

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