State Role
SAMHSA works throughout the country, including localities, states, counties, and territories to deliver behavioral health services (Substance Abuse and Mental Health Services Administration, 2017). The state’s role includes choosing and demanding what services are offered to the individuals in that area, promote and ensure rules and other demands for the delivery of mental health, substance abuse services, and work together with local governments to reduce these types of illnesses, and oversee the health care delivery overall within this service statewide (Substance Abuse and Mental Health Services Administration, 2017).
The Affordable Care Act has a different approach for their states, where states have to establish ways for
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For the treatment expenses and productivity, mental illnesses and substance abuse is estimated to be around $500 billion each year (Substance Abuse and Mental Health Services Administration, 2015). The Affordable Care Act mainly focuses on financing and making more individuals able to receive care through their funding. The Affordable Care Act has many ideas in place to reduce the behavioral health care costs for patients, to expand the coverage of Medicaid, and to ensure the best quality of care provided. With these new ideas, not only will Medicaid expand to cover more people in need, but the Affordable Care Act may start new financing tools such as the use of payment models, and there will be a change in the coordination, care and the savings between the providers of behavioral health, the payers, and the patients (Mclellan, & Woodworth, 2013).
Medicaid:
It is known that this type of illness does not receive much of the spending for health care, therefore Medicaid is an important factor in the funding of treatment for mental and substance abuse illnesses. SAMHSA has stated that under the Affordable Care Act Medicaid is going to expand covering more substance abuse patients (Substance Abuse and Mental Health Services Administration, 2017). Many of
The existence of Affordable Care Act have been a promising act for millions of citizens, especially the effort to end homeless, to put low-income on a better care at a reasonable price, and the access to healthcare through a variety of healthcare insurance choices. Its’ purpose is to reform healthcare, creating new policies, and establishing a better accessibility to physician and hospital with a cost that fit within both side budgets. The Act guarantees subsidies to all patient with an offering to better practitioner and treatment options to create a strong incentives to improve the quality of cares and services (Meek, 2012, pg. 15). Nevertheless, The Affordable Care Act face many barriers such as
The Arkansas Health Care Payment Improvement Initiative (“AHCPII”) is one part of the health care innovations the state has implemented with the aim of “increas[ing] health care quality and reducing the costs of care.” The AHCPII’s intent is to shift Arkansas’s payment system from “one that primarily rewards service volume to one that rewards desired outcomes, particularly with respect to quality and affordability.” Applying to Medicaid, Medicare, and private payers, payment innovation will move away from fee-for-service health care (where quantity all too often trumps quality) to pay for quality. In doing so, the hope is that Arkansas will gain a “new, sustainable model of financing” with the help of a multi-payer leadership and support.
Cost Mental disorders, other than alcohol and substance abuse, cost U.S. society more than $204.4 billion annually. About $91 billion of that amount (based on 1994 figures) is for direct health care costs; the rest includes social services, disability payments and the expense of lost productivity. Estimates for the annual costs of some specific mental disorders:Major depression: $43.7
According to the World Health Organization, mental illness will affect approximately 25% of people at some point in their life (“WHO Qualityrights”, n.d.). Despite that, the current mental health care system in the United States is inadequate. Many aspects of the system need improving, especially the barriers to service. In fact, approximately 20% of individuals are left without necessary treatment for their mental health disorder (“Mental Health”, 2016). Mentally ill individuals have difficulty accessing necessary mental health care services for various reasons; insurance, socioeconomic status, and mental health stigma can all function as barriers to treatment. Insurance discrimination can make it difficult for individuals to find treatment (Han, Call, Pintor, Alarcon-Espinoza, & Simon, 2015). Gaps in insurance coverage can also be a barrier, as they disrupt the long-term treatment process (Gulley, Rasch, & Chan 2011). Socioeconomic status has been found to negatively affect appointment scheduling (Kugelmass, 2016). Finally, stigma in our society can also stop people from seeking out treatment that they need (Bathje & Pryor, 2011). The mental health system in the United States is not capable of caring for the mentally ill, as insurance, socioeconomic status, and perceived stigma all act as barriers that prevent people from receiving the treatment they need.
The Affordable Care Act (ACA), also referred to as ObamaCare, is a complex U.S healthcare reform that attempts to expand and improve access to healthcare and decrease spending through taxes and regulations. The main goal of the ACA is to provide more Americans with affordable health insurance. States vary in when and how they implemented the ACA in order to meet the needs of their state in hope to decrease the uninsured population. Every state had the option decide whether to offer healthcare through a state-based or a federal marketplace. Some states sued the federal government questioning whether they even had to right to impose this act. New Mexico and Pennsylvania are just two of the states that have had to figure out a way implement the Affordable Care Act. Each one had to take into consideration several factors including their state population, the demographics of that population, how many uninsured people there were, and the economy of their state. They both had the public plans such as Medicaid, Medicare and Children’s Health Insurance Program (CHIP) options as well as new federal subsidies that would now be offered depending upon income. Since there is no “one size fits all” health plan each state was challenged to make the best decisions using the tools available to them. This information was then used to formulate a plan that would give the most people access to affordable healthcare in each of these
The Affordable Care Act (ACA) which was passed by Congress was implemented to improve the quality of health care and reduce the cost of health insurance in the United State. America spends more on health care than any other industrialized nation in the world. In North Carolina, the governor signed a bill to block the state from extending the ACA which will allow Medicaid to cover group of individuals that are uninsured. North Carolina rank 33rd of the 50 states in population measures in 2012 and rank 38th in health outcome (Siberman, 2013). In 2010-2011 approximately 1.7 million people were uninsured and had barriers to access health care in North Carolina as
With the implementation of the ACA, many states have expanded their Medicaid programs to include a larger population of low income individuals and families that were not able to obtain health insurance prior to the law. Some of the issues that state legislators struggle with are the overall cost of providing services for the additional recipients, staying within budget, determining an adequate approach of offering quality care, and providing adequate coverage for each recipient. Even though the cost of Medicaid expansion within each state has increased the budget for the program, new appraisals has shown that Medicaid programs spend less per enrollee than commercial health insurance and much of the increase in Medicaid expenses originate from the increase in enrollment in the programs (Coughlin, Long, Clemens-Cope, & Resnick, 2013).
Through the ACA, The Mental Health Parity and Addiction Equity Act was formed to assist individuals get through specific barriers that are up within the health care of behavioral health (Huang, Fong, Duong, & Quach, 2015). Other than that, the Affordable Care Act has started to provide expansions of coverage through systems such as specific insurance and Medicaid to the services of mental health and substance abuse (Beronio, Po, Skopec, & Glied, 2013).
The Florida state government is directly involved in this public health policy, since it is has the authority to make changes to the federal-state run Medicaid program. The Sunshine state has opted out from the Medicaid expansion program under the ACA. The Governor of Florida Rick Scott (Republican) endorsed Medicaid expansion, however the state’s GOP-led legislature rejected it. The Republicans have a majority in Florida state-legislature, whereas the ACA act was passed by the Democrats-led federal government under President Obama. The federal government could not require states to adopt the Medicaid expansion. The states must proactively enact legislation to expand their Medicaid program. Since it is non-binding on the states, the state legislatures have the final word whether or not to participate in the expanded Medicaid
In 2010 during the term of President Barack Obama something needed to be done due to the rise of healthcare costs and the number of people who were uninsured and unable to pay their healthcare bills (ehealthinsurance 2014). United States spent more on healthcare than any other country but yet was only the 34th in life expectancy. These are some of the many reasons why The Affordable Care Act came about and was signed into a health care law. This landmark law impacted and changed many aspects of the healthcare system, as well as influenced everyone’s healthcare options in the United States. The Affordable Care Act has been just about been one of the most
Medicaid provides medical assistance to citizens in the United States who fall within the eligibility requirements. Medicaid has been enacted since 1965 and has faced many changes. One change most recently was the Patient Protection and Affordable Care Act, and the attempt to require states to expand Medicaid coverage to include more citizens. However, Medicaid is a states’ right and therefore Congress decided to leave expansion up to each individual state. As some states decide to move forward with expansion and some do not, this paper will discuss the pros and cons to each option and the financial impact that Medicaid expansion has on healthcare entities.
Did you know that 19.9 percent of adult Americans had some sort of a mental illness, according to the Substance Abuse & Mental Health Services Administration (samhsa.gov, 2015, Para. 3). This is a total of 45.1 million adults in America suffering with mental health disorders (samhsa.gov, 2015, Para. 3). There are also currently 20.8 million adults in America who suffer from substance use disorder ever year (NAMI.org, 2015). Both of these are alarming statistics of the wellbeing of the American citizens. To make matters worse, these two groups intertwine to a population of people known with a co-occurrence of mental illness and substance use or, more commonly known as, dual diagnosis.
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).
Once the foundation of the U.S. health care system was reviewed, we began our study of the new regulations. The Affordable Care Act contained three main provisions. The first provision was expanding Health Insurance Coverage. Elements of the regulation included offering coverage to the vast majority of currently uninsured Americans by expanding access to Medicaid to cover all non-elderly individuals below 133 percent of the federal poverty level (FPL), and establishing state-based health insurance exchanges, which will offer Americans a range of private health plan options, with federal tax
The ACA requires insurers to accept all applicants, cover certain conditions, and charge the same rates despite one 's sex or pre-existing health status. There are ten provisions that make up the ACA which were to be implemented over time, from 2010 through 2020. The first provision is individual insurance, which prohibits insurers to deny coverage based on one 's pre existing health conditions. States were also required to make insurance available to children who are not insured through their families. Medicaid was also expanded to include individuals and families with an average income of thirty thousand dollars a year. This mandate will not cover those who are illegal immigrants, eligible individuals who choose to not be enrolled in medicaid, those who choose to pay the penalty, individuals whose insurance would cost more than 8% of their income, and those who live in states that opt out of the medicaid expansion.