Social Conditions. Escalating During The Great Recession

The Great Recession was the general economic decline observed in world markets around the end of the first decade of the 21st century. The Great Depression was a severe worldwide economic depression in the 1930s.

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.

In March 2010, one of the most controversial bills in modern history was signed into law by President Barack Obama. The Patient Protection and Affordable Care Act expanded the 1965 bill passed under President Johnson that created Medicare and Medicaid (“LBJ Presidential Library,” 2015). While the Affordable Care Act, or “Obamacare” as it has been dubbed by the media, has many components, the focus here is the expansion of Medicaid. Obamacare sought to expand Medicaid to cover those who earn too much to qualify for traditional Medicaid, but not enough to afford employer-provided health care. These people are said to be in the “coverage gap” (“Obamacare Medicaid expansion,” 2015). While only 32 states have adopted Obamacare, we should advance a policy encouraging the remaining states to expand existing coverage by extending the period of federal government cost-sharing an additional five years. Doing so would give states previously refusing the cost sharing a second chance to opt-in. This expansion would save money for the states from some of the rising cost of healthcare, and fulfill our moral duty to care for uninsured Americans.

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

However, these are microcosms of a person’s total being that must be treated and care for as well. The Affordable Care Act outlines guidelines for “essential health benefits” that must be covered by every insurance company, “ Obamacare 's "essential health benefits," which include ambulatory and ER care, hospital stays, maternity and newborn care, mental health and substance abuse services, prescription drug plans, rehabilitative care, and lab work. Dental and vision care is covered until a child reaches age 19”, (KidsHealth). It is important that when maintaining one’s health, not only the physical aspects are considered. Mental health and social health ultimately affect one’s physical health as well. That is why counseling services and rehabilitation centers are at an extreme need because mental health and substance abuse rates are at all times highs in our communities and our country. The repercussions of these can be felt on the physical body through side effects and neurological imbalances, which also lead to heart disease, stress, and stroke. The highest “silent killers” in our nation.

Seven of the thirty-three states that adopted Medicaid expansion obtained section 1115 Medicaid demonstration waivers. These waivers allow states flexibility in operating state-specific Medicaid programs beyond what is available under current law. Indiana is among the seven states that are using a Federal waiver to continue its seven-year-old Healthy Indiana Plan instead of implementing the traditional Medicaid expansion offered by the ACA. The Healthy Indiana Plan, also known as HIP 2.0 since 2015, is a health insurance program for uninsured adults with income at or below 138 percent of the Federal poverty level.1 Indiana Medicaid has three programs for patients with serious mental illness, emotional disturbances, and substance use

As stated in the article “Medicaid Spending: A Brief History”, the Omnibus Budget Reconciliation Act (OBRA-1981) decreased federal contributions in states where growth exceeded certain goals; this was a three-year reduction which cut matching rates by up to 4.5% in 1982, 1983, and 1984. Eligibility changed as well which made it increasingly difficult for families to receive Medicaid coverage. Reductions in federal contributions led to flexibility provisions that “broadened State options for providing and reimbursing Medicaid benefits, as well as State authority to limit coverage under medically needy programs” (Klemm, 2000). This led to experimentation with alternative options such as Health Maintenance Organizations to manage services and costs because most

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

Regardless of where one stands, one must admit that the American economy is not thriving. Not only is it not thriving, but also the American economy has either been in depression or on the verge of depression for the last decade. Because of this, parity seems to be a dream. It is not the prime time to push for the ACA, perhaps during the 80’s or 90’s, but there were other political dilemmas that needed to be dealt with. Another factor to take into account is the reaction of the healthcare system once it truly has to cover for mental illness treatment. Because there is an immense amount of cost, around $131,000(Abelson), to

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.

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).

In 2010, the Affordable Care Act invoked a $75 millon dollar demonstration project known as the Medicad Emergency Psychiatric Demonstration that was amended in section 2707 of the Affordable Care Act (ACA). The change seemed to be just what the nation needed, however, there was fine print added to the amendment that changed the interpretation. The fine print stated, patients who are on Medicaid from the ages of 21-65 seeking inpatient mental health care can receive treatment under the law. However, the inpatient facility will receive no

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

How has the 2008 crisis affected your studies covering wealth and poverty? Did any approaches to understanding what is going on in today’s world change?

Despite the overall success of the International Monetary Fund and the United States to prevent additional contagion from the Mexican peso crisis throughout the broader global financial systems, the crisis nevertheless proved devastating to the Mexican economy and its population. The devaluation of the peso and capital flight plunged the Mexican economy into a deep recession, national GDP dropped by 6.2% throughout 1995, and multiple banks collapsed as poor quality assets and fraudulent lending practices came to light, forcing the financial sector to bare the brunt of the crisis (Pereznieto, 11). The average Mexican, however, would argue otherwise and angrily proclaim that it was them that suffered the most. Many Mexicans could no longer keep up with the rising interest rates and thousands of mortgages went into default, resulting in widespread repossession of homes. Prices rose by 35%, hyperinflation resulted in a real wage decrease of 25-35%, and unemployment rose to 7.4% in 1995 from its 3.9% pre-crisis the year prior (Pereznieto, 15). In the formal sector, over a million people lost their job, real wages decreased by 13.5%, and overall household incomes plummeted by 30% (Pereznieto, 15). Extreme poverty in Mexico grew to 37% in 1996 from 21% in 1994 (Pereznieto, 16). The growing poverty in Mexico also impacted urban areas more than rural areas (Pereznieto, 15). Urbanites relied on a healthy labor market, good access to credit, and