HHS wrote that the purpose was to offer merely “a small number of meaningful choices.” Letting people make tradeoffs for themselves “would have allowed extremely wide variation across plans in the benefits offered” and “would not have assured consumers that they would have coverage for basic benefits.” Forced equity again trumped individual choice.

Hard to believe, but at the time liberals complained that this HHS “essential health benefits” rule wasn’t restrictive enough. Pediatric services stop being required at age 19, not 21, and what about speech therapy, medical foods or lactation services?

Liberals needn’t have worried. Once customers are herded into the exchanges, HHS has the power to further standardize benefits, further limit choices by barring certain insurers from selling through selective contracting, and generally police the insurers to behave like the government franchises they now are. The state-run exchanges in Vermont and the District of Columbia have already barred individual coverage outside their exchanges.