Blog: ACA

The Affordable Care Act: Changing Mental Health Treatment in America

One aspect of the Obama Administration’s Affordable Care Act that’s often overlooked in the media is its attention to mental health and substance abuse treatment.
Overall the landmark legislation hopes to bring near universal health insurance to the United States when the last round of its major provisions goes into effect on Jan. 1, 2014. These provisions include the controversial individual and employer insurance mandates.
But the law goes further though than just getting people insured, it aims to improve the American health care system, especially in the areas of mental health and substance abuse.
Mental health and mental health policy have been favorite topics in the news these last few years with the tragedies in Tucson, Aurora, and Newtown. Pundits from all sides have found a new pastime in discussing and arguing over how the system should be changed.
Opinions aside mental health and substance abuse are serious issues in America. About one in every four adults can be expected to experience a mental illness during the course of a given year, according to stats from the National Alliance on Mental Health (NAMI). That’s nearly 55.7 million people, no small number for a nation of 315 million.
That number of adults rises to one in 17 when talking about more serious mental illnesses like schizophrenia, major depression, or bipolar disorder. For younger Americans the rate continues to climb with one in 10 children living with a serious mental or emotional disorder, according to NAMI numbers.

Substance abuse is estimated to cost the United States over $600 billion annually. A 2012 survey conducted by the National Institute on Drug Abuse found that among teenagers alcohol and cigarette use has declined in recent years but the use of illicit drugs is on the rise.
So it’s no wonder that the Care Act looks to extend coverage and improve treatment of mental health and substance abuse. Let’s take a look at some of the ways it aims to do that.

Affordable Care Act Expands Mental Health and Substance Abuse Benefits for 62 Million Americans

According to an issue brief released Feb. 20 by the Department of Health and Human Services (HHS), the Affordable Care Act will extend mental health and substance use disorder benefits to 32 million and federal parity protections to an additional 30 million Americans.
The HHS report explains that to do so, the Affordable Care Act will build upon the existing federal parity law, the Mental Health Parity and Addiction Equity Act of 2008. Applying to group health plans and insurers, this law requires that when provided, coverage for mental health and substance use conditions be comparable to that for medical and surgical care. However, gaps in coverage currently leave millions either without such benefits or without parity protections.
In surveying coverage before the Affordable Care Act, the report finds:

  • One-third of those currently covered in the individual market have no coverage for substance use disorder services, and nearly 20% have no coverage for mental health services. Even when individual market plans provide these benefits, the federal parity law does not apply to these plans.
  • More common than in the individual market, about 95% of those with small group market coverage have substance abuse and mental health benefits. Again, the federal parity law does not apply.
  • 47.5 million Americans lack health insurance coverage altogether, and 25% of uninsured adults have a mental health condition or substance use disorder or both.