 [ Symptoms ] why is the aca a one size fits all policy why do we have to pay for health services that do not pertain to us [ Disease ] i would not describe the aca as a one size fits all but it does create a minimum set of benefits that all plans in the individual and small employer market must cover note nearly all large employer plans already cover these benefits previously most plans in the individual market did not offer very comprehensive coverage and had a number of exclusions e g maternity mental health coverage even cancer treatments the idea behind insurance is that it is spreading risk across a large group of people at any point in time many people will be healthy and will not need to go to the doctor