3 Mental Health Care Provisions in the Affordable Care Act

The Affordable Care Act (ACA) has passed, been okayed by the Supreme Court and had many of its provisions kick in already, affecting the health and wellbeing of Texans right now. Access to affordable, comprehensive health care is a major success we can be proud of, but what about mental health care? Well, don’t you fret. There are several areas in which the Affordable Care Act will improve the lives of those suffering from mental health disorders:

Mental Health Care as an Essential Health Benefit

The Affordable Care Act spells out a list of mandated categories of coverage that insurance plans will now be required to include in an individual’s benefit package. And guess what? Mental health care – including substance abuse and behavioral health services – is one of the ten categories. This is a big deal, because in the past mental health often wasn’t treated like other health services. Insurance companies will no longer be able to exclude mental health care benefits from their general package of benefits or offer it as a more expensive supplemental package.

Mental Health Parity

Mental health benefits must match physical health services offered under the law. This means whatever the day and visit limits, dollar limits, coinsurance, co-payments, deductibles, and out-of-pocket maximums are for physical health care, that same standard should apply to mental health. Providing mental health services at “parity” with physical health services has been required of some insurance markets since 1996, but the ACA expands parity to nearly all insurance markets.

Integrated Mental and Physical Health

The Affordable Care Act also promotes the growing trend to provide individuals with integrated care, which means meeting physical and mental health care needs in the same location. Integrated care has been shown to improve health outcomes for individuals by insuring they get all the services they need in one stop and by getting doctors to talk and work together for their patients.

Integrated care “health homes” will be set up with federal funding to build the infrastructure needed for patients to receive comprehensive care management, care coordination, health promotion, and comprehensive transitional care for inpatient to other settings, including follow-up care and individual and family support. Each of these services would greatly benefit people coping with physical and mental health disorders at the same time.

The Affordable Care Act makes some substantial jumps in access and quality of care for those with mental health disorders, but there are several ways in which Texas could utilize the ACA further:

  1. Make the Medicaid program available to the newly qualified ACA population.
  2. Enforce mental health parity laws.
  3. Invest in the mental health workforce.
  4. Take advantage of federal dollars to implement integrated health strategies.

Talk to your state legislators and advocate for taking full advantage of the Affordable Care Act so that those who struggle with mental health disorders can receive the help and assistance they need.

Written by: Clayton Travis, Texans Care for Children