Acupuncture Added As Essential Health Benefit in California

Acupuncture will be considered an “essential health benefit” in California and will be covered by individual and small group health plans starting in 2014.

On Sept. 30, Gov. Jerry Brown signed measures SB 951 and AB 1453, which included acupuncture to be covered under the federal health reform also known as the Patient Protection and Affordable Care Act (PPACA) that was signed into law on March 23, 2010.

The health care law will require all insurance plans to cover a specific set of benefits. The health law includes 10 broad categories that must be included, leaving the specifics to every state. The legislation establishes the minimum health benefits that must be offered to consumers.

The two measures included acupuncture as an essential health benefit that the state can begin to offer through federally subsidized plans for individuals and families as well as unsubsidized plans.

According to the plan, patients would pay a $30 co-pay for acupuncture services to treat “nausea and chronic pain.”

This is the first step to full implementation of the ACA in the state of California. During his term as California governor in the 1970s, Gov. Brown had legalized the practice of acupuncture and strongly supported the rights of chiropractors, osteopaths and lay midwives.

During the past year, the American Association of Acupuncture and Oriental Medicine (AAAOM) and many of its national and state partners were actively engaged in the public debate on the definition of Essential Health Benefits (EHB).

The AAAOM EHB Task Force had submitted a Summary Report to the Institute of Medicine (IOM) in support of acupuncture as a potentially-covered EHB. In that report, the group outlined both the criteria HHS should use to determine specifics of the EHB package and the benefits of including acupuncture in this benefit package.

The core of the message was that acupuncture increases patient choice and improves overall cost-effectiveness of American healthcare through prevention and its integration with mainstream medicine.

The AAAOM EHB Task Force also worked with the office of Congresswoman Judy Chu (D-CA) to designate acupuncture as a covered as an essential health benefit under PPACA. After running a national letter-writing campaign, the group was able to gather 23,000 letters, which were sent to HHS to comment on the first EHB bulletin.

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