The Affordable Care Act expanded Medicaid coverage to millions of low-income people living in America, and that aid includes mental health coverage. This lesson will detail some of the ways the Affordable Care Act has had an impact on Americans’ ability to obtain mental health services.
The Affordable Care Act
It you paid any attention to the news in the last few years, you’ve probably heard rhetoric about the Affordable Care Act. This act, which combines two separate piece of legislation (The Patient Protection and Affordable Care Act and The Healthcare and Education Reconciliation Act of 2010), both expanded Medicaid coverage to millions of low-income Americans and improved both the Medicaid and Children’s Health Insurance Program (CHIP).Regardless of which side of the fence you lie on politically concerning the Affordable Care Act, it’s hard to deny that it changed the healthcare landscape in America.
Importantly, it changed how low-income Americans receive mental health coverage and services.
Essential Health Benefits Include Mental Heath Coverage
When enacted, the Affordable Care Act sought to make healthcare coverage and plans easily accessible to a large population of Americans. All of these plans must cover 10 categories of essential health benefits. These are categories of various health services that every person with a health care plan under the Affordable Care Act must be covered for.For example, trips to the emergency room are considered an essential health benefit under the Affordable Care Act.
Therefore, any person who is covered under a plan through the Affordable Care Act must have their emergency room visits covered.The important thing, regarding mental health, is that the Affordable Care Act includes mental health and substance abuse services as an essential health benefit. Therefore, any person who is covered under the Affordable Care Act will have their mental health and substance abuse services covered under their plan.
Mental Health Parity and Addiction Equity Act of 2008
Before you can begin exploring additional ways the Affordable Care Act impacts mental health, it’s important to understand what coverage looked like before the act was passed. In 2008, the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was passed.
This act essentially made it so that group health insurance providers had to cover mental health and addiction services in same way that medical and surgical services are covered. So, for example, there could not be any limitations placed on mental health services that would not be placed on medical benefits.However, it is important to note that this act only applied to large group healthcare coverage. It did not apply to small group (fewer than 100) and individual healthcare coverage.
Additionally, it did not require providers to cover mental health and substance abuse services. It simply required that, if both medical/surgical and mental health/substance abuse services are covered, that they be treated equally.
Expansion of MHPAEA
The Affordable Care Act builds on and expands MHPAEA. This expansion means that small group plans and individuals are now also included. Therefore, millions of people can now receive mental health and substance abuse benefits that are generally comparable to their medical and surgical benefits, no matter if they are covered under a large or small group, or individually.
For example, behavioral health services, such as outpatient therapy, must now be covered in much the same way as outpatient medical services, such as doctor’s appointments. This makes mental health services more accessible to low-income individuals and those in small-group plans.
No Limit, No Waiting Period
Aside from expanding mental health coverage and building on MHPAEA and make the coverage comparable to medical coverage, the Affordable Care Act included a few other requirements for mental health coverage.
First, coverage can’t be denied or delayed on the basis of pre-existing mental health conditions or substance abuse issues. This means that coverage for these services begins immediately when your coverage starts, with no waiting period. Next, the Affordable Care Act mandates that no yearly or lifetime dollar limit can be placed on essential health benefits, which includes mental health and substance abuse coverage.
The Affordable Care Act expanded Medicaid coverage to millions of low-income individuals and made improvements to both Medicaid and the Children’s Health Insurance Program. This law made mental health and substances abuse services essential health benefits, which means they must be covered under a health plan obtained through the Affordable Care Act.
Additionally, it expanded coverage parity to individuals and small-group plans so that mental health and medical services are comparable.The Affordable Care Act had a huge impact on mental health and substance abuse coverage for low-income individuals. Regardless of where you stand politically, when presented with the facts above, it’s hard to deny that it is serving many people in desperate need of care for mental health issues.