Insurance Discrimination Outline

Although Medicaid may sound generous, the program has many narrowing limitations. Numerous restrictions prevent the program from being offered to everyone who is poor and cannot afford medical care. Eligibility for the program is not based on need alone, but is also affected by age, family status, and medical condition. Beyond the federal programs Medicare and Medicaid, inhabitants of the United States must look to private organizations to provide their healthcare. People may enroll in these independent health insurance plans through their employer or on their own if they can pay for it.

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.

Mental health in America is a stigmatized topic that affects nearly 20% of the population and around 1 in 4 people will be affected by a mental illness at some point in their life (World Health Organization, 2010). However, due to the stigma behind mental health, people often do not seek treatment. As for the homeless population, the rates are much higher, with 1 in 4 homeless individuals living with a severe mental illness (Jasinski, Wesely, Mustaine, & Wright, 2005). These people and this population struggles to receive adequate healthcare, but with the enactment of the Affordable Care Act (ACA) or better known as ObamaCare, there have been positive change made to help these individuals. However, the ACA is not perfect and there are

Problem Statement: The World Health Association defines ‘good’ health as: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” However, in the United States, access to care and funding for mental health care are grossly neglected and underfunded in comparison to other aspects of health care.

An interesting finding by Huskamp and Iglehart (2016) is that between the Mental Health Parity Act (MHPA) and the Affordable Care Act (ACA), there should be a rise in people with mental illness seeking services, however, services are underutilized more than ever (Huskamp & Iglehart, 2016). According to Bendant (2014), in 2013 a total of 47 million people uninsured and 25% of those suffer mental illness (Bendant, 2014). These numbers are staggering for a service that is more inclusive now more than ever. The Center for Medicare & Medicaid Services (CMS) site indicates that the MHPA is regulated differently depending on the state (CMS, n. d.). The Department of Labor (DOL) has identified a few problems with the MHPA and addressed these issues to Congress via a 2017 report (DOL, n.

Even with some especial programs like ACA, a lot of people can’t afford for coverage due to extreme rate of poverty.”Cost still poses a major barrier to coverage for the uninsured. In 2015, 46% of uninsured adults said that the primary reason they were uninsured was because it was too expensive, making it the most common reason cited for being uninsured”(Key

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).

Policy plays a key part in mental health care services available to the public. They can determine what options and treatments are available and how much an individual will pay for them. Recent policies including the Mental Health Parity and Addiction Equity Act of 2008, the Affordable Care Act, and the Children’s Health Insurance Program Reauthorization Act work to expand access to coverage. It is important to know how policies play a role in the health care that individuals receive.

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.

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)

The insurance cost to companies can be insurmountable in relationship to hospitalizations, medication costs, and professional fees for the psychiatrist, therapist and other mental health professionals. Individuals with severe mental health illnesses often rely on government programs to assist them in meeting their financial needs. Because of the social stigma of the mentally ill population, making friends and finding social supports are difficult. The Sioux City community has established a program for developing social supports.

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.

Access to mental health care is not as good as than other forms of medical services. Some Americans have reduced access to mental health care amenities because they are living in a countryside setting. Others cannot get to treatment for the reason of shortage of transportation or vast work and household tasks. In some areas, when a

There are great health care benefit programs for employees in most organizations. However, the age limitations are causing serious concerns when it comes to mental care for dependent adults over the age of 26. This needs to change, as mentally ill patients over the age of 26 are left without healthcare insurance; which is never a good thing. Mentally challenged individuals deserve to be protected and covered as dependents under their caregiver’s insurance plans as long as they live. The term dependent should not be restricted to an age, but rather be a term that defines the individual who is unable to provide for themselves due to some mental disorder. Therefore, if organizations change their policies and include the mentally ill as a dependent regardless of age, then, it is likely for economies to see declining crime rates, less cost to taxpayers for essential services, and better overall rehab facilities.

It is illegal to unfairly discriminate or permit any unfair discrimination by offering different rates or policy terms or benefits between individuals of the same rate and hazardous classification. For example, assume married and single individuals are in the state rate and risk group (either by legal mandate or by actuarial data). If all other risk factors are the same between the married and the single applicant, an insurer cannot use marital status as a basis for discrimination by charging the single applicant more than the married applicant or by denying coverage to the married applicant and granting coverage to the single applicant. ***