With Obamacare now almost five years old and nearly in full force, health insurance plans that include mental health insurance must also ensure that the mental health benefit is equivalent in quality and scope to the medical benefit that is also offered under that same plan. Many states also Under federal law, insurance plans that cover mental health must offer benefits that are on par with medical and surgical benefits. For example these insurance plans must not charge higher co-payments or deductibles for mental health services. Also, the plans must not force patients to gather additional professional authorizations beyond what would be required for medical health services in order to get mental health services.
However, compliance with these new requirements is typically falling short, according to many professionals and mental health advocates. “The fact that health plans have not been transparent about approving or denying care means that providers are flying blind and consumers are losing out,” said Sita Diehl, director of state policy and advocacy for the National Alliance on Mental Illness.
According to some health care professionals and government agencies, Obamacare has also muddied the waters. Implementation of the Affordable Care Act has been overwhelming to both States and the federal government that an exhaustive survey and enforcement of compliance with many requirements of the law has been put on the back burner. Further, enforcement of the various insurance requirements Obamacare’s are divided between the States and the federal government and both have been scrambling to bring Obamacare into general operation.
Some professionals and mental health advocates also cite the long-standing stigma attached to mental illnesses to be the main barrier to ensuring that the proper benefits are in place. These, and a general view of mental health being ‘unscientific’ have combined to place a lower importance on mental health in the ongoing public health debate.
“I can’t help but feel that the stigma associated with having a mental health or developmental disability impacts the zeal with which regulators want to get in on this issue,” said Ele Hamburger, a Seattle attorney who said she has won more than a half-dozen settlements against insurers on parity grounds. “That stigma is so widespread.”
Innerlife STS is a cloud-based clinical platform for treatment reports, data collection and analytics, documentation, and outcome tracking related to mental health care and its integration with primary medical care.