Question

The Affordable Care Act has expanded mental health and substance abuse benefits to 62 million people and is an addition to the Mental Health Parity Act of 2008. The changes and additions require mental health coverage in small group and individual plans where people were not previously covered.

What is the biggest benefit of these changes? What major challenges are still associated with mental health coverage?

Explain your reasoning

Answer 1

Ans) The biggest benefit of the ACA is that it slows the rise of health care costs. It does this by providing insurance for millions and making preventive care free. This means people receive treatment before they need expensive emergency room services.

- Before the Affordable Care Act was enacted, mental health coverage was often lacking from health plans sold in the individual market. One in five American adults will experience a mental health issue at some point, but historically, millions have not gotten the care they needed due to the challenges of the health insurance market.

- And in recent years, the opioid epidemic has cast a spotlight on the need for substance abuse treatment, which falls under the umbrella of mental/behavioral health care. Medicaid expansion — a cornerstone of the ACA — has dramatically expanded access to addiction treatment in some of the states that have been hardest-hit by the opioid epidemic.

Huge challenges of covering mental health
In 2013, a person with a bipolar diagnosis was unable to obtain private individual health insurance in most states. The same was true for people with schizophrenia and other psychotic disorders, anorexia, alcoholism, and a variety of other serious mental or behavioral illnesses.

Even for people with relatively minor mental health diagnoses, health plans were allowed to increase premiums during the initial underwriting process.

- The underwriting rules that applied to mental health treatment often trapped people in the health plan they had when they were diagnosed, with no realistic opportunity to shop around when annual rate increases were announced. And for people who were uninsured at the time of their diagnosis, securing coverage was challenging and expensive – or impossible, depending on where they lived.

For those who had insurance, it often didn’t cover mental health care. According to a 2013 analysis conducted by HealthPocket, only 54 percent of individual health plans in the United State included coverage for substance abuse treatment, and 61 percent covered mental health treatment.