by David Heymsfeld, AAPD Policy Advisor
“Open microphone” meetings are being convened in major cities by the US Department of Health & Human Services. These forums enable advocates and others interested in the implementation of the Affordable Care Act to comment in-person on the essential health benefits (EHB) – the core of health services which must be provided in health plans available through health insurance exchanges starting in 2014.
The purpose of the meetings is to get public input on the requirements established by the 2010 health care reform act for the health care services which must be covered by health insurance (“essential benefits”)
AAPD suggests that persons appearing at these hearings discuss specific services which they believe must be covered, based on their own knowledge and experience.
The types of services which could be discussed include:
- services needed to enable persons with significant disabilities to learn or keep the skills and functions needed for independent living and working in the community (the technical term is “habilation.”) This could include occupational therapy, physical therapy, and speech therapy. The services could include training persons with disabilities in communication skills, medication management, personal hygiene skills, behavior management, and social skills For example, teaching social skills to a person who developed schizophrenia at an early age; teaching people with developmental disabilities how to administer their medication safely or the fine motor coordination needed to dress themselves; and physical therapy to prevent a decline in function for a person with a congenital spine condition. These services could prevent the need for costly institutional care.
- durable medical equipment needed to improve a persons mobility, hearing, vision, and the ability to communicate. This could include prosthetic limbs , orthopedic braces, durable medical equipment (such as power wheelchairs), and other assistive technology.
- Necessary services should not be subject to arbitrary and unreasonable limits, such as limits on the number of visits, limits on the number of prosthetic limb per lifetime, or unreasonable limits on the costs of durable equipment.