Is Obamacare serious about mental health? That is the question at the center of an emerging conundrum among the nation’s mental health experts, insurance companies, and public policy officials. In recent study results published by, Johns Hopkins Bloomberg School of Public Health stated that nearly 25% of the health insurance plans under Obamacare appeared to run counter to a federal law requiring ‘parity’ in coverage for patients with mental health disorders or substance addition problems. The study was led by associate professor Colleen Barry and published in the journal Psychiatric Services. As part of the study, Dr. Barry completed an exhaustive review of the marketing brochures for the 2013-2014 Obamacare enrollment period. Dr. Barry found that, despite federal assurances that Obamacare would implement mental health parity; insurance coverage for mental and physical illness remains unequal.
In a separate review, The federal Substance Abuse and Mental Health Services Administration (SAMHSA) published a 2013 report stating that 9.6 million US adults exhibit major mental illness, such as major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post traumatic stress disorder and borderline personality disorder. Mental health patients need specially-designed, individualized treatment and might also need psychiatric medications as part of their therapy and treatment. Uninsured patients likely delay or even live without proper assessment and treatment. An untreated mental illness is one of the major root causes of unemployment, homelessness, substance abuse, and even suicide. Many persons with mental health disorders ultimately end up in prison which, according to estimates by the National Alliance on Mental Illness, cost the US about $100 billion each year.
CEO of Mental Health America Paul Gionfriddo predicts a “bump in the road where access gets a little more constrained,”
“We haven’t been hearing about access issues from our members,” stated National Association of State Mental Health Program Director Stuart Gordon.
Obamacare requires adults with incomes up to $11,670 a year for an individual and $23,850 for a family of four to receive health coverage that is either free or extremely low-cost. The Supreme Court ruled that the states may decide, individually, whether to expand Medicaid. So far, nearly half of the states have decided not to expand Medicaid, but states could change their plans at any time. Obamacare requires parity for group health insurance policies and Barry says “As of Jan. 1, 2014, insurance plans on state exchanges were also required to offer plans with equivalent cost-sharing and prior authorizations for mental and physical health.”
“This makes it nearly impossible for consumers to find the best plan to cover their mental health needs,” said Dr. Barry. “It’s critical to monitor whether these regulations are being implemented in a way that fulfills the promise of parity. Clearly, better monitoring is needed.”
But Clare Krusing, spokeswoman for America’s Health Insurance Plans, an insurance industry trade group says, “The rules contained some important changes affecting plan design that were only required for insurance plan years that started on or after July 1, 2014. It is unfair to say a plan doesn’t offer mental health parity.”
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