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Monday, September 27, 2010

Mental health disparities get a check up

Kate Blocher

Staff Writer

Last week we celebrated September 23, the six-month anniversary of the signing of the Affordable Care Act. On September 23, several consumer protection provisions took effect, bettering the lives of millions of Americans. Although it hasn’t been discussed much, these provisions and other parts of the health reform law will have a special positive effect on the lives of the millions of Americans suffering from mental health or substance use disorders.

For years, insurance companies have placed mental health below physical health, ignoring the fact that both affect one’s well-being. As a result, navigating our insurance system can be even more treacherous for those with mental health and substance use health disorders. It is estimated that one-fifth to one-third of the uninsured are people with mental health or substance use disorders.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and the rules for the law issued by the Obama Administration earlier this year mark great strides to improve the lives of those with mental health and substance use disorders. They  prohibit insurance companies from setting more restrictive limits on mental health or substance use care than those that are in place for physical health care. However, there is still a long way to go to ensure that people with mental health disorders are receiving the care they need.

For example, a mental health disorder can be considered a pre-existing condition, making it harder for people with mental health problems to find insurance in the individual market. So what happens if people with mental illnesses lose their jobs? Or if they graduate college and are thrown into the individual market? Thankfully, the Affordable Care Act helps those with mental health and substance use disorders get the quality care they need:

With the passing of the Affordable Care Act, individuals who would be denied coverage elsewhere due to their pre-existing mental health or substance use conditions are now able to enroll in the Pre-Existing Condition Insurance Plan.

Starting on or after September 23, young adults will be able to stay on their family’s health insurance plan until the age of 26. This provides a new important protection for young adults with mental health or substance use disorders who might not be able to find quality, affordable coverage elsewhere.

Also starting on or after September 23, insurers will no longer be allowed to place dollar limits on how much care they’ll cover for enrollees over the course of their lifetime. There will also be new restrictions on annual dollar limits, which will be outright prohibited starting in 2014. These protections are critical for people with mental health or substance use disorders, who will no longer “run out” of coverage because of lifetime or annual caps.

Starting in 2014, insurance companies will no longer be able to deny anyone due to a “pre-existing condition,” meaning the diagnosis of a mental health or substance use disorder will no longer be a barrier to purchasing health coverage. For children up to age 19, this protection takes effect starting on September 23, 2010. Also in 2014, mental health and substance use disorder services will be part of the essential benefits package, a set of health care services that must be included in most individual market and small business health plans and ALL plans offered on the Exchange.

For more information on how the Affordable Care Act will help those with behavioral health disorders, watch this webchat put on by the Department of Health and Human Services. Secretary Kathleen Sebelius discusses how provisions in the new law will help ensure that those with behavioral health disorders receive the coverage they need. You can also view a full list of the health reform protections that went into effect starting on September 23 here.  

Dealing with a mental health or substance use disorder is difficult enough on its own, but having to do it without affordable access to health care can be devastating. Provisions in the Affordable Care Act will ensure that those dealing with these debilitating diseases will no longer have to struggle to get the care they need.