Under the ACA, can health plans impose lifetime or annual limits on essential health benefits?

The Affordable Care Act (ACA) was enacted to enhance health care coverage and accessibility for individuals and families. One of its significant provisions is the prohibition of lifetime and annual limits on essential health benefits. This means that health plans qualified under the ACA cannot set a cap on the total amount they will pay for essential health services over a lifetime or within a year. This regulation is designed to ensure that individuals have access to necessary medical care without the fear of exhausting their insurance coverage.

By prohibiting these limits, the ACA aims to protect consumers, especially those with chronic conditions or serious health issues that require extensive medical treatments. Such protection ensures that individuals can receive the care they need without facing financial barriers that could arise due to imposed limits.

Other options suggesting that limits may be imposed, whether generally permitted or only for specific age groups or dependent on the type of health plan, do not align with the ACA's foundational goal of providing comprehensive and equitable health coverage. Therefore, the assertion that health plans are generally prohibited from imposing lifetime or annual limits on essential health benefits is an accurate reflection of the ACA's mandates.