“The Affordable Care Act marks a tremendous step forward in our efforts to improve access to care for individuals with mental health or substance use conditions and in our advocacy for prevention of these conditions,” said David Shern, Ph.D., president and CEO of Mental Health America.
“Treatment for these conditions is recognized as critical to overall health by being included on the list of essential benefits that must be covered in new plans offered to the uninsured beginning in 2014.”
Dr. Shern said several key provisions that take affect on September 23 will improve the lives of millions of Americans with mental health and substance use conditions. These include:
Children under the age of 19 can no longer be denied coverage based on a pre-existing condition. (This provision will be extended to adults in January 2014.)
If a parents’ plan provides coverage for dependent children, it is now required to cover children up to age 26.
Insurance companies can no longer set limits on the dollar amount of health benefits that they will cover in a year or over an individual’s lifetime.
All new plans must offer co-payment- and deductible-free preventive services, including depression screening for adolescents and adults.
The groundbreaking enactment of the “Mental Health Parity and Addiction Treatment Act” (MHPAEA) firmly established that discriminatory limits on mental health and substance use conditions will no longer be permitted. The Affordable Care Act carries this principle forward and extends the MHPAEA requirements beyond current law to health insurance plans offered to small businesses and individuals. These principles are also reflected in the expansion of Medicaid which would require those newly eligible to receive mental health and substance use services at parity with other benefits.
Access to care will also be improved due to insurance market reforms in the new law that will prohibit pre-existing condition exclusions, rescissions of coverage when people most need it, pricing premiums based on health status, and annual and lifetime limits on benefits.
The requirement that coverage for dependent children must be available up to age 26 and additional funding for school-based health clinics are critical in light of the fact that mental health conditions often strike during the adolescent and young adult years but most will not receive treatment until many years later, if at all.
Mental Health America is announcing new changes in the world of insurance which is the result of years advocacy.
"Mental Health America places a high priority on prevention, particularly among children and youth, and recognizes the critical importance of the requirements to cover preventive services and support for support community-based prevention activities.
Among the many other important new programs and reforms are initiatives to support education and training of additional mental health and addiction treatment providers and to improve coordination of care through a new state option for medical/health homes in Medicaid that includes individuals with serious mental health conditions among the priority populations.
Additional information on how the Affordable Care Act affects mental health treatment and services is available at: http://www.mentalhealthamerica.net/go/action/policy-issues-a-z/healthcare-reform."
Wednesday, September 22, 2010
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