Nevertheless, some groups are exempted from these user fees, such as children under the age of 6 and people over the age of 65, low-income groups, pregnant women, people with severe disabilities and people with many different medical conditions. Concerns are growing regarding individual regions' ability to provide the services that the benefit package defines at the national level. When the first Essential Levels of Care were published in 2001, the legislation only provided a general description of the sublevels of care that regions had to provide.