Analysis: The ACA Mental Health Expansion

Mental illness is nondiscriminatory, can affect any person and transcends all social boundaries. As a result, the issues surrounding mental illness have become common discussion pints among policymakers dedicated or required to formulate solutions around providing the long-term care needed by many patients. Healthcare reforms and changes to the systems that provide services to those living with mental illness and funding for services to the facilities providing care have become major social issues (Goldman, Morrissey, Ridgley, Frank, Newman, & Kennedy, 1992). The reason for this is primarily how it can affect a market economy and how much of a burden diseases of the mind can be in a country such as the United States. According to the 1991 Global Burden of Disease study conducted by the World Health Organization mental health burden accounted for “more than 15% in a market economy such as the U.S.” (The Impact of Mental Illness on Society, 2001). The study also states that for individuals over the age of 5, varying forms of depression are the leading cause of disability. A more recent study indicates that mental illness in general is found in more than 26% of the United States adult population, of which 6% are severe and limit the patient’s ability to function (Martin, p. 163. 2007).

I read a news article on Medscape which talks about increasing access to mental health care. The rule require provisions of the Mental Health Parity and Addiction Equity Act of 2008 to apply to the majority of Medicaid plans and the Children’s Health Insurance Program (CHIP) (Brooks, 2015). The act ensures that mental health and substance use disorder benefits are no more restrictive than medical and surgical services (Brooks, 2015). I strongly believe that individuals deserve access to quality mental health services and substance use disorder services. In addition, improving quality and access to care will impacts the health of our nation. The proposed rule ensures that all beneficiaries who receive services through a managed care plan or

This article presents a policy analysis of the Mental Health Parity Act of 2007. It focuses mainly on the impact of the new legislation on the existing state parity laws. 54 million Americans are impacted by mental health issues each year costing the United States nearly $100 billion dollars annually (Marth, 2009). In relation to Mental Health coverage prior to the new legislations; individuals did not receive coverage similar to other physical and surgical medical treatments. As a result of inadequate treatment, this particular population can sometimes lead to unhealthy lifestyles and habits. The cost of Mental Health services and treatment can be extremely expensive including coy-payments, treatment visits, and other resources. However, this

Medicaid care plans struggle to provide mental health services and with the expansion of Medicaid under the Affordable Care Act many individuals will gain access to healthcare and also to behavioral health coverage. Though the Affordable Care Act outlined changes to make access to mental health service easy, it is still a struggle to make this happen. It is upto the plan, states and other stake holders to ensure there is access to

throughout Missouri, Strangler used his experience and power to persuade legislature to provide the funds.

The original purpose of the Affordable Care Act (ACA) was to address the rising amount of healthcare cost in the United States, and substantially increase the amount of Americans insured with access to affordable healthcare. The ACA allows for the expansion of Medicaid; the government health insurance program, which is designed to increase enrollees for low income families in Medicaid. With this new legislation people who are under the age of 65 who are at or below 133 percent of the poverty line will have access to Medicaid. Anyone who earns below 400 percent of the poverty line will qualify for subsidies for health insurance. (Cockburn, 7) Americans who earn above this level must either buy insurance, or use their employer’s coverage. This is a huge implication because the estimated of new enrollees in 2014 estimated by the Congressional Budget Office is between 16 and 17 million. The federal government has agreed to finance this expansion of Medicaid for the first three years of implementation, for states that agree to the program. After these three years the states will have to start to pay a small portion of Medicaid. Many people with substance abuse problems, and mental disorders without insurance, are low income earning childless adults. (Bainbridge, 5)Under the ACA these Americans now have access to behavioral health treatment, in the 26

Seeking to improve care and lower costs, Florida became the first state to offer a Medicaid health plan designed exclusively for people with serious mental illnesses, such as schizophrenia, major depression, or bipolar conditions. The plan offered by Connecticut-based Magellan Complete Care - is part of a state experimentation to co-ordinate physical and mental healthcare for those enrolled in Medicaid. Mental illness is a big driver of Medicaid costs because it is twice as prevalent among beneficiaries of the public insurance program for the poor as it is among the general population. Studies show that enrollees with mental illness, who also have chronic physical conditions, account

Mental Health coverage prior to the Affordable Care Act was far to none. With about nearly one-third of currently covered individuals having no coverage for substance abuse disorder services and approximately 20% having no coverage for mental health services. Services such as outpatient therapy visits, impatient crisis intervention and stabilization were among many that were not offered. Since the Affordable Health Care Act has been passed more individuals are able to afford health insurance that were once uninsured. It has helped many individuals in being able to obtain medical services that were once inaccessible.

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is an act that requires parity or equality between mental health treatment and medical/surgical treatment covered by private and public insurers with over 50 employees. That means that if an insurance covers mental health issues they can’t impose more stringent limits and financial requirements than medical/surgical coverage. The act was signed into law in 2008 by President George W. Bush. Before the act was signed into law, mental health care was not as affordable or accessible for individuals. (United States Department of Labor, 2016)

In the United States alone, approximately 20% of Americans experience a mental illness in a given year, and 1 in 25 Americans live with a serious mental illness that significantly impacts one or more life activities (NAMI.org, 2015). These disorders span across the lifetime, many starting by the age of 14, and mental health care is often the root of progress or hindrance for a person whose life is impacted by these unseen disorders. Though it is not always evident that an individual is experiencing mental illness, these complications influence the daily lives of millions of people worldwide, regardless of age, culture, race, religion, or other delineation. As a result, it is vital that this sector of healthcare be thoroughly examined for inefficiencies,

In today’s society there is a greater awareness of mental illnesses. With this greater awareness one might assume that there would be a substantial increase in government involvement or funding in the area of mental illness treatment. Unfortunately this isn’t the case in the U.S. today. There are hundreds of thousands of people with mental illness that go untreated. These potential patients go untreated for many reasons. These reasons are discussed in the Time article “Mental Health Reform: What Would it Really Take.

What is left is that we have many citizens who are mentally ill and are not receiving treatment. However the patients who are able to receive treatment are only able to have some treatment covered. Health insurers are responsible for covering the immensely large cost of substantial treatment, a mixture of medication and therapy; since therapy is highly priced, less reliable, and time consuming; patients typically do not receive treatment for therapy. Health insurers would much rather cover medication because it is cheaper, it heals patients faster, and it is more reliable than therapy. However, medication is not made to heal, but to only coax symptoms of a mental illness (Sandberg).

According to stateline.org, “In 2014, 43.6 million adults had a mental illness... Fewer than half of these people received treatment” (Ollove). Mental health disorders are a growing epidemic in the United States. Tens of thousands are diagnosed each year, however few decide to seek treatment. Costly medications and treatment options are often to blame, as they are difficult for patients to afford. Mental health care coverage should be included in all health insurance plans because mental health disorders should be treated the same as any physical illness, it benefits society as a whole, and many mentally ill patients cannot afford necessary medication or care.

Just last year 1 in 5 Americans suffered from mental illness. Everyday Americans and people in other countries are suffering because of mental illness and they should be treated to matter the cost. Mental health has just as much effect on the body as does physical health. Which that comes to my essential question. Should health care companies cover mental health treatment? One side says yes because that would help millions of people with getting treatment because the cost is too extensive for them. But on one side of the claim some people say that the cost is too severe to cover everyone’s mental health treatment through insurance. Nevertheless, It is extremely essential that no matter the cost that people are being treated for their mental illnesses. Many people are suffering from unfair treatment from insurance companies with mental health issues to prove that I will talk about that people really do suffer, that mental health patients really do want help and lastly that it is legally deemed to be treated the same insurance wise.

Lack of access to mental health care and treatment is one of the top ten reasons that many mental health conditions go untreated. Many private and group health insurance plans only include minimal mental health care coverage or do not incorporate mental health care coverage at all. Over half of adult citizens of the United States of America, who possess a mental illness, do not obtain mental health care treatment. According to the U.S. Department of Health and Human Services, one out of every five adults in America have endured their own mental health difficulty, and one out of every twenty-five American adults suffer from a severe mental illness, such as major depression, schizophrenia, or bipolar disorder. (Top 5 Barriers to Mental Healthcare Access, Social Solutions.com, 2017)