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.
Wish the federal promises delivered . BUT, discrimination is lawful in California. We are fighting to change state/fed Medicaid policy that guarantees mental health parity for everyone–except people with mental illnesses. Medicaid insurance does not cover “medically necessary” treatment for anyone disabled by a mental illness. There is no guarantees for any standard of treatment regardless of age or severity of illness. The detailed gobbledygook of a federal “waiver” authorizes California to isolate mental health in a separate public system. The Medicaid entitlement to essential treatment for physical medicine is stripped away for mental illnesses.
Join the Right to Treatment campaign, see https:/facebook.com/mentalillnessfacts.
Parity is not paid for in California.
Not exactly. While ACA does extend Medicaid benefits, it only extends them to people who don’t need long term hospitalization, i.e, not the sickest. Also, ACA reduces payments to “Disproportionate Share Hospitals”, those that serve a lot of people with mental illness who live below poverty. I wrote on this at http://www.huffingtonpost.com/…/affordable-care-act… Feel free to use it as a guest blog.
This article is a spin-off of the article published in my blog on June 30th: http://www.dreampositive.info/looking-ahead-to-the-affordable-care-act-how-can-it-make-americas-mental-health-system-better/
Looks like the author (Michael Cahill) submits the same content in all popular blogs :-(
Well, we’ll see…
It is unrealistic to implement such a massive undertaking without glitches. Problems and unforseen issues comes with the territory. Hopefully, not stupid ones – like deadlocks in congress. However, the fact that we’re even taking steps to make healthcare available in this country is a big breakthrough. We’ve actually moved beyond discussion to implementation.
Among developed countries, the U.S. stands almost entirely alone in terms of widely available health care. This means there are many existing models to study and learn from. It is also an opportunity to change some of the ways we think about health care (e.g., more emphasis on preventative care to help keep costs down as opposed to treating diseases as they occur).
Even if it fails, it is better than simply turning a blind eye to the inequities currently prevalent in health care accessibility.
To those in power with scowls on their faces:
Be skeptical, yes! But don’t stand around with arms crossed waiting for problems to spring up so you can say, “I told you so!” Be willing to take this on with creativity and ingenuity instead.
That is about all the hope I can muster on this issue. We’ll see…
I’m so happy hear this — I was diagnosed with BP ll last month and I’ve been worrying about how I’d afford care because I’ll have to switch part-time when I return to work and my current insurance plan isn’t availiable to part timers at my job. What a relief!
Traci – You don’t understand. As a young person with bipolar disorder, I would not be able to receive treatment or medications if it weren’t for Obamacare. I am currently in college and I am working my ass off to make it to the middle class. If I was unable to stay on my mother’s insurance I would remain in poverty for the rest of my life, but because I am able to get the treatment I need, I can make it to the middle class and be able to contribute to society in the future. Programs like Obamacare keep mentally ill people like myself medicated and productive members of society. Would you rather have a bunch of uninsured people who are mentally ill and not able to care for themselves? Trust me when I say that scenario is going to cost the middle class much more than Obamacare ever would.
Andrew-People like you who blame others because you never ‘made it to the middle class’ make me sick. Many of us weren’t born into the middle class, we worked our ASSES off to get here. It shows your idiocy to believe otherwise . From the age of 12 I had a hardship license. I got up at 5am to pick the garden, went to school then went to work with my dad. I worked in the commercial construction industry-I hated it! I KNOW manual labor. Yes I am a girl but I can drop ceiling tile, install FRP, shoot metal studs and hang drywall. My parents didn’t have much but they took great pride in what they did have and in the fact that they earned it. I learned from an early age to save. I put 10% back of EVERY penny I made. I bought my own car. I paid for junior college without help from the freaking government or my parents. I am here because I saved and made good choices. I don’t OWE you a DAMN thing. Stop feeling sorry for yourself. Sometimes things happen, and sometimes things suck but that doesn’t mean society owes you. My dad is 70. He still works construction-in the field and in the office. My mom is 67 she has 2 acres of garden that still she picks and sells You deal with the hand you were dealt and be thankful for what you have and help others when you can.
Just FYI I am not a ‘whiner’ , I try and make my voice be heard whenever I can. I vote, write letters, sign petitions, stay involved in my local government, attend rallies for causes I truly believe in and keep up with current events.
Break the backs of the middle class? I’m tired of hearing Whining about how hard it is going to be for the middle class. You middle class people have been and are still breaking the backs of the poor by paying them just enough to keep them poor and the companies you work for find every way possible to get every penny these people make! I’m 55 years and I have spent my life in school got my degree and my job went over seas and so I spent most of my life working ( manual labor) and I don’t even have a retirement account out side of SS which will be nothing by time it is my turn to get that. I did not vote this stupid bill in but since it DID I’m not going to be griping about it. I knew it was a bad deal! Walk a mile in a poor Man’s shoes and then try whining about your loss.
Steven try and look at the WHOLE picture. They oppose it because of the COST. Right now, my family of 5 has health insurance that costs us 7,200 per year. Because of Obamacare, our premiums next year will be 25,000 (yes 25 THOUSAND DOLLARS). Simply put, Obamacare sucks because it will be breaking the backs of the middle class. My family can’t afford that outrageous premium, nor do we qualify for subsidies. We will be FORCED to pay the penalty for declining the insurance while the poor get it all or FREE. . I live in ‘suburbia’ we are not rich. My neighbors are not rich. Everyone in my circle that I have talked to is in the same boat and we are scared. Our family will go from having great healthcare coverage-including mental health to no coverage at all. Thanks Obama. Who has the best interests of the people at heart? There has got to be a better way-Obamacare ain’t it!
Excellent and informative article. No wonder Boehner, Cantor and their cronies oppose it. Heaven forbid we should ever have fairness on the treatment of mental health issues! Didn’t you know parity was only for the wealthy?