FRIDAY, Oct. 11 (HealthDay News) -- As the nation's health-care
law continues to roll out, people with mental health issues are
discovering ways that the landmark legislation directly affects
An estimated 32 million people will gain mental health or
substance use disorder benefits, or both, as a result of the
Affordable Care Act, according to the U.S. Department of Health and
Much of this will stem from the requirement that small group and
individual insurance plans offer coverage for mental health issues
and substance abuse services. Most large insurance plans already
include such coverage.
In addition, "parity has been written into the law so mental
health coverage ostensibly should be much easier to access," said
Susan Lindau, a licensed clinical social worker and associate
adjunct professor at the University of Southern California School
of Social Work in Los Angeles.
Parity means that coverage for mental health issues, for
instance, must be comparable to the coverage provided for general
medical and surgical care. The Affordable Care Act expands the
limited parity that was first introduced into law in 2008.
However, Andrew Sperling, director of legislative advocacy for
the National Alliance on Mental Illness (NAMI), is somewhat
circumspect about the upcoming changes.
"We're still waiting for the final regulations," he said, noting that the government has promised that information by year's end. "And, because of the Supreme Court decision, the Medicaid expansion is optional, and a large number of states are talking about not participating." Because some benefits vary depending on where people live, he explained, people in some states won't see the full benefits accorded by the law.
However, changes that should help those seeking mental health
The financial aid provisions and the expansion of Medicaid
should be a boon to a host of people with mental health issues,
according to NAMI.
"There are a high percentage of people that have a diagnosable mental illness living below the poverty line," Sperling said.
However, many of the rules people in the mental health community
aren't fond of, such as prior authorization for treatment and a
specified number of allowed treatment sessions, were not changed by
the health-care law.
"Evidence-based practice does have standard lengths of time for support," Lindau said. "Someone may be in treatment for post-traumatic stress disorder, and evidence may suggest that 12 weeks is the standard, and once someone is out of the extreme crisis, group treatment may be an option."
Though some want no limits on the number of treatments available
for someone with a mental health disorder, the law now mandates
that all insurers offer a length of treatment that's on par with
what's available for other health issues.
"It's like someone who's diagnosed with diabetes," Lindau said. "In the beginning, the treatment and education is very intense, and after time there are fewer appointments."
The bottom line on the Affordable Care Act, according to
Sperling, is that "many people will be able to get new coverage or
will see insurance coverage for mental health improve
As Lindau noted, "right now, people often wait until things are
really terrible, and then they need additional help." But many of
the difficulties people have faced in getting mental health care
reimbursement should diminish, if not disappear, as the health-care
law goes into full effect. "I think it's going to be a great
thing," she said.
HealthCare.govoffers a guide to the Affordable Care Act,
including aspects that relate to mental health.
one woman's strugglefor insurance coverage for a
treatment program she says saved her life.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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