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Mental Health Parity in the Affordable Care Act Praised

Mental health disorders have long carried with them a stigma. People with mental illnesses are often treated as being in some way inferior to others. They are thought to have a weakness, rather than an illness. With more advanced research being conducted, experts are getting a better understanding of mental disorders and how they have biological, physiological and developmental origins. In other words, a person can no more help having a mental illness than a physical one.

In spite of the gains being made in the understanding of mental illnesses, health care and insurance programs have been slow to change their ways. Many insurance plans include little to no coverage for mental health. The Affordable Care Act, also known as Obamacare, may change all that. Mental health advocates hope to see greater equality in coverage as the law takes effect.

Mental Health Care Limitations

Many insurance plans do offer some mental health care, but limitations are common. Most plans, for instance, put a cap on the number of days each year a patient can be hospitalized for mental health treatment. There are also often limits on the number of days of hospitalization in a row. Most plans also limit the number of outpatient therapy sessions.

For acute cases of mental health issues, such as depression brought about by grief over the death of a loved one, the coverage available is typically enough. But, if you struggle with lifelong bipolar disorder or schizophrenia, the limits make getting adequate care nearly impossible. Getting more care often requires out-of-pocket payments.

One of the reasons for these limits is that mental illnesses are often chronic and require lifetime treatment -- that can get pricey. Why limits on mental health care have been deemed acceptable for so long may be related to the attitude most people, even doctors, have toward mental illness. With a physical illness, you can see the problem, and treat or fix it. Mental illness cannot be seen. It is a more difficult concept to grasp, and as such seems to many like less of a problem than a physical disease.

The Promise of the Affordable Care Act

The Affordable Care Act (ACA) is expected to expand access to mental health care by requiring insurers to offer equal coverage for physical and mental health needs. A law passed a few years earlier required certain insurers to include the same limits for mental and physical health coverage, but the ACA should expand it even further. The mental health parity law helped some people who already had insurance, but had little to no impact on the poor who had no insurance coverage at all. Even those with insurance still did not get equal coverage because of loopholes in the law.

With the ACA requiring people to have insurance, making insurance plans more affordable, and expanding the Medicaid program, more people should have access to insurance that covers mental health care. Another important aspect of the ACA is that insurers cannot deny coverage to people with pre-existing conditions. This will be a huge benefit to those with mental illnesses shopping for an insurance plan.

The parity portion of the ACA states that coverage must be the same for mental, physical, behavioral and addiction care. If a plan places limits, the limits must apply equally to all types of care. Whether this will really have an impact is still up for debate. Many people working in the mental health professions are hopeful, but also have concerns. One problem area is the fact that the parity aspect of the ACA applies to new insurance plans only. More than one-third of workers are insured by plans that will be grandfathered in and that will not have to apply the new parity rules.

The real-world outcome and impact of the ACA’s new expansion of mental health care parity remain to be seen. There is no way to know just what kind of affect it will have on those who need better mental health care coverage or how far-reaching it will be until the law goes into effect in 2014. Regardless, the inclusion of mental health care in the law is certainly a step toward making real change.

Posted on November 12th, 2013

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