A great deal of controversy has arisen over the cancellation of health insurance policies which do not meet the requirements of the Affordable Care Act. It is important to note that these cancellations have nothing to do with employer-provided health insurance. They are affecting, at most, about 5 percent of individual plans and are affected because they offer substandard insurance, which is exactly what these cancellation letters say (though not in so many words). Premiums may be low, but sometimes coverage is quite limited.

Under the ACA, we cannot be refused insurance because of a pre-existing condition. Policies cannot be canceled because a serious illness has developed. There are no annual or lifetime limits on coverage. This is not the case with many individual policies.

In addition, essential health benefits must be provided under the Affordable Care Act: outpatient services, emergency services, hospitalization, maternity care, mental health services, prescription drugs, rehabilitation, laboratory services, preventive services, and pediatric services. This is a tall order, but which of these services do you think are unnecessary? When a letter comes from an insurance company canceling an individual policy because “it doesn’t comply with the Affordable Care Act,” the company is saying that it is substandard insurance. You may pay your premium and have inadequate coverage when you need it.

In order to have universal health insurance and to have a program in which citizens can get needed help with their premiums and out-of-pocket costs, it is absolutely necessary to have an idea of what health insurance should cover. The Affordable Care Act has problems, but one of its strengths is that a great deal of thought has gone into exactly this question.

Serafin Anderson

Wilton

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