What can the Affordable Care Act (Obamacare) do to Improve America’s Mental Health System?
The Bipolar Burble blog welcomes guest poster Michael Cahill of Vista Health Solutions. Michael discusses the critical implications of the Affordable Care Act for people with mental illnesses.
Since the 2008-2009 financial crisis, America has put funding for mental health treatment on the back burner. Consequently, mental health services and facilities nationwide have suffered.
In the wake of tragedies like Aurora and Sandy Hook, the government is now determined to address the issue of mental health policy in the United States, which will be no easy task.
What will surely go a long way towards helping those suffering from a mental illness will be getting them access to treatment and making that treatment affordable. According to the Substance Abuse and Mental Health Services Administration, the high cost of mental health care is the number one culprit for people not getting treatment. Even those with health insurance often have significant limitations on their access to mental health services.
The Affordable Care Act (ACA), sometimes more commonly referred to as Obamacare, has great potential to improve access to mental health treatment and make it affordable. Here are five ways it can do it:
1. Minimum requirements will include mental health coverage.
Starting in 2014, all health insurance plans are required to cover medical services in ten “essential health benefits” categories as mandated by the ACA. This includes treatment for mental health, behavioral disorders, drug addiction, and alcohol abuse.
No doubt this is a big improvement over previous years when nearly 20 percent of people who bought health insurance on their own did not have mental health coverage. A further third had no coverage for substance abuse treatment, according to the U.S. Department of Health and Human Services.
2. Patient rights will be protected.
Insurers can no longer discriminate based on a customer’s medical history. That means you cannot be denied coverage or charged extra because of any pre-existing condition.
The new law also gets rid of lifetime and annual caps on spending for your health benefits. This is great news for people who suffer from mental health disorders who would normally rack up thousands of dollars in bills every year from their treatment.
3. Health insurance exchanges will make it easier to purchase health insurance.
The creation of health insurance exchanges is also a mandated measure under the ACA. These exchanges are the new marketplaces where health insurance companies will present their plans to potential customers. Each state will have its own exchange with enrolment starting later this year on Oct. 1, 2013 for coverage rolling out on Jan. 1, 2014.
Those who suffer from mental health illness will have an easier time comparing plans and purchasing the one that suits them. Four different levels of plans with varying degrees of coverage will be available in the exchanges. All of them will include mental health benefits.
Low income Individuals and families can also find out at the exchanges if they qualify for government subsidies through the exchanges. Those who earn between 133 and 400 percent of the federal poverty line will not spend more than 9.5 percent of their income on health insurance. The 9.5 percent is also a sliding number, so those earning less will pay less for coverage.
4. Medicaid coverage will be expanded.
A study conducted by the National Alliance for Mental Illness, found that the planned Medicaid expansion that’s part of the ACA will extend coverage to more than 2.7 million uninsured Americans with mental health disorders.
Those who are qualified will receive a 100 percent subsidy for the first three years and at least a 90 percent subsidy for the next seven years. Those who earn up to 133 percent of the federal poverty line will be included in the expansion.
Unfortunately, the Medicaid expansion will not be available everywhere. Fourteen states have rejected the expansion while twenty states and the District of Columbia have signed up to implement it.
5. Quality and availability of service will be improved.
The Affordable Care Act also includes measures that will help to improve the quality and delivery of healthcare services.
Treating mental illness is an expensive and complex endeavour, and response to treatment varies among patients. Mental health practitioners often see patients going in and out of treatment.
Monitoring and re-evaluating the delivery of care is important to improve mental health coverage. Affordable Care Act has mandated the creation of the National Strategy for Quality Improvement which aims to improve healthcare delivery across the country. It will prioritize high-cost chronic diseases such as mental illness.
The Care Act will also establish the Centers for Excellence in Depression. Its goal is to develop coordinated and integrated care, encourage positive health behaviors and outcomes, and promote interdisciplinary training of mental health professionals.
Michael Cahill is the editor of theVista Health Solutions blog. Follow him on Twitter at @Vistahealth and @Electronicmike.