Employee Retirement Income Security Act ( Erisa ) And The Mental Health Parity And Addiction Equity Act

Medicaid excludes inpatient hospital services other than services in an institution for mental disease. Congress specifically exempted most psychiatric care in state hospitals (Davoli, 2003)

The causes of these mental illnesses can be attributed heavily to discrimination on almost all fronts. The impact of institutional discrimination, that is discrimination that is passed through laws or amendments in a state or federal level, has been shown. It had been shown that the prevalence of mental illness is higher in states that do not provide protection from discrimination such as in the work place and in marriage (the bans of the time of

When considering the American medical system, it is clear that the policy solutions for disparities occurring outside the clinical encounter

Across the country, a steady increase has been noted in the number of patients presenting to emergency departments for psychiatric complaints (Zun, 2014). Patients also attempt to use their primary care doctors to treat their mental illnesses. The mental health care options for these patients are extremely limited, especially for minority populations such as African Americans and Hispanics. One out of four adults in America suffers from some form of mental illness, yet only one out of three of those affected receives treatment (Safran, 2009). Furthermore, patients are routinely misdiagnosed, receive poor quality of care, receive care from providers who have no understanding of their cultures and values, or are not even able to receive care in the first place (Sanchez, 2012).

Individuals with a mental health illness tend to experience discrimination due to misinformation, assumptions and stereotyping. Many people in our society are not educated on the subject of mental illnesses and often have misconceptions about the conditions and what affects these pre conceived ideas can have on the individual suffering from the

Substance abuse has been a known topic which has not been recognized and fully treated the way it should. Unlike general medicine, substance abuse treatments have their own facility and services apart from general settings, making it harder to get the recognition and the assistance needed to help the individuals in need. Both the Affordable Care Act and the Substance Abuse and Mental Health Service Administration (SAMHSA), which is a part of the US Department of Health and Human Services have promoted and established ways to enhance the quality of the treatment and the amount of treatment given.

Senate (S.) 689 is the Mental Health Awareness and Improvement Act of 2013, which resanctions and increases critical behavioral health programs through superior federal education and healthcare programs related to awareness, early identification, and prevention of mental illness (The Library of Congress, 2013). United States Senators Tom Harkin (D-IA) and Lamar Alexander (R-TN) pioneered S. 689 on April 9, 2013 (The Library of Congress, 2013). There are 23 co-sponsors of the Mental Health Awareness and Improvement Act of 2013, including 14

Policy analysis of mental health care under the ACA as well as description of how mental health care/service are organized under the ACA from federal to local levels.

The issue regarding the lack of healthcare in America is prominent but is a more significant issue than what is commonly known. For instance, it is not publicly recognized that those who are mentally ill are covered by the same healthcare as those with conventional ailments. Because of this, money becomes an issue; health insurers cannot cover every case, or cannot fully cover any case. The Affordable Care Act (ACA) and Patient Protection Act, both part of “Obamacare,” were passed in order to fix this very issue; these acts are ultimately attempts to reach parity. However, the chance to have healthcare that fulfills parity, equality of coverage, has passed, the ACA is too late and it is time to come up with new solutions. To settle for

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)

The bill’s primary sponsors are Senator Peggy Lehner and Senator Jay Hottinger. Its committees are House Community and Family Advancement and Senate Health and Human Services. The House Community and Family Advancement is the House of Representatives standing committee and the Senate Health and Human Services is in charge of reviewing legislations on health care and issues in Ohio (LegiScan, Ohio SB127 | 2015-2016 | 131st General Assembly, n.d). Once a bill is put on a committee they are now put on the agenda to be discussed at the next meeting.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008. MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Federal Register, 2013). The MHPAEA is an extension of the Mental Health Parity Act of 1996, which prohibited annual or aggregate lifetime financial limits on mental health coverage by addressing other restrictions, such as limits on outpatient visits or inpatient days (DOL, 2010). MHPAEA expands parity requirements to treatment limitations, financial requirements, and in- and out-of-network covered benefits (Smaldone, 2010). It also expands the opportunity of mental health parity requirements at the federal level and includes substance use disorders within its scope. Prior to 1996, health insurance coverage for mental illness had historically been less generous than that of other physical illness (Sarata, 2011). Mental health parity is a response to this disparity in insurance coverage, and generally refers to the concept that health insurance coverage for mental health services should be offered equally with covered medical and surgical benefits (Smaldone, 2010).

As a result of the Community Mental Health Act being passed, psychiatric facilities began to see budget cuts, making it more difficult for individuals to manage their symptoms (Markowitz, 2011).

Preceding the enactment of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, approximately forty-nine million individuals in the United States were uninsured. The Mental Health Parity and Addictions Equity Act (MHPAEA) does not command or require coverage for mental

Policies have an important role in regulating and shaping the values in a society. The issues related to mental health are not only considered as personal but also affecting the relationships with significant others. The stigma and discrimination faced by people with mental health can be traced to the lack of legislation and protection of rights (Rodriguez del Barrio et al., 2014). The policy makers in mental health have a challenging task to protect the rights of individuals as well as the public (Swigger & Heinmiller, 2014). Therefore, it is essential to analyse the current mental health policies. In Canada, provinces adopt their own Mental Health Acts (MHA) to implement mental health services. As of January 15, 2016, there are 13 mental health acts in Canada (Gray, Hastings, Love, & O’Reilly, 2016). The key elements, despite the differences in laws, are “(1) involuntary admission criteria, (2) the right to refuse treatment, and (3) who has the authority to authorize treatment” (Browne, 2010). The current act in Ontario is Mental Health Act, 1990.