Mental Health Parity Case Study

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.

March 23, 2010 is a significant date for the United States. Following a long and controversial political and legislative process President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This pushed for the most significant changes to the United States health care system since Medicare and Medicaid back in 1965. The main stance of the act is to offer affordable benefits for all people including those who cant afford it. The Affordable Care Act includes a series of reforms that positively expand on the existing system of employer-sponsored insurance (ESI). It creates new requirements for individuals, employers, health care providers, and insurance companies (French, 2016). The ACA includes multiple strategies to target different populations and increase insurance coverage. It has offered many changes to medical benefits, treatments, as well as the quality of life. Specifically under the ACA, benefits for those who are struggling with a substance use disorder are mandated. One of those expansions in the ACA is the Mental Health Parity and Addiction Equity Act (Advanced Recovery, 2016). This act ensures that insurance companies offer coverage for mental health disorders and treatment. A brief yet significant statement in the ACA states those with substance use disorders will be classified as suffering from a mental health disorder. The coverage for those who have struggled with an addiction allows for understanding on how

The piece of this health reform act related to mental health stipulates that there be state laws mandating or regulating mental health benefits ("NCSL," 2012). This author has found no literature that indicates the effectiveness of the PPACA. Perhaps it is too early to determine the success or failure of the PPACA.

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).

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)

It has particularly helped in response to the currently increasing costs associated with the rapidly increasing growth of mental health care problems. As mental health care cost continues to increase at a bigger rate compared to other healthcare areas, managed care has made efforts to contain this rising costs. Managed care programs have helped in containing reimbursed mental health care costs offered to employees and their families/dependents (Pires, Armstrong & Meyers, 1998). Managed care for mental health services is usually provided to its providers on a fee-for-services making providers paid on every service billed. Managed care has, therefore, reduce substance abuse care, psychiatric cost, implicitly and hospital use of mental

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.

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).

Avik Roy of the Manhattan Institute for Policy Research wrote an editorial last September in USA Today titled “Not Affordable Care Act: Opposing View” (Roy). In his editorial, he argued, “it (the Affordable Care Act) mandates that insurers cover services that the government deems ‘essential’, such as drug-addiction therapy, that most people don't need.” Contrary to Roy’s opinion, health care reform that includes drug-addiction therapy is not only critical, but necessary, as our nation deals with the harsh realities of overdoses related to heroin and prescription pain killers. The services required to be covered by health insurers under Obamacare for people struggling with substance abuse will come as a

The concept of a social problem is a condition, event, or situation that constitutes as troublesome that needs to be changed. A social problem is not considered to be a social problem unless it is seen as a violating or threatening the fundamentals of society. They span the entire spectrum of the population; white, black, Indian, and Hispanic; men, women, and children. No race is exempt; homelessness is an equal opportunity social issue. The service learning project raised awareness of the underlying issues, factors, and reasons that create homelessness.

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.

A social problem, is “a general factor that effects and damages society”. It can be used to describe an issue or a problem within a certain group of people or an area in the world. Examples of contemporary social problems today include anti-social behaviour, drug abuse, and sexual abuse. Poverty is an example of a social problem that exists all over the world, and to different extents. In the UK, poverty has effected at least a third of the population, as shown by the Office of National Statistics, providing evidence that it is a massive social problem in the country. Tameside has a big poverty problem. 1 in 4 children in Tameside are born into poverty, and workers in Tameside earn significantly less than other workers in the rest of the North-West area. In addition, Tameside has the largest proportion of people claiming unemployment benefits compared to the rest of the North West of England.

-One reason why the authors argue that this is a social problem in need of change is that

Many people wonder, what is a social problem? Social problems are all over the world and affect many people. The definition of a social problem is an aspect of society that a large number of people or community are concerned about. They depend on your values or if you believe something is good or bad. There are two kinds of social problems, objective condition and subjective concern. An objective condition is a condition within society that can be measured. Subjective concern is an aspect of society that many people are concerned about. Social problems are major events that affect a lot of people. The social problem I will cover is poverty.

In analyzing social problems in today’s communities our begin to implement Social Welfare Programs that addresses these social problems. Social Problems are based on three factors which are: the force and societal position of the individuals who are characterizing the issue and encouraging the consumption of assets toward an answer, people in the community being affected by the social problem, and the measure of devastation to society based on the social problem that has not been dealt with (Chambers, 2012)