Mental Health Care Benefits Under Affordable Care Act (Obamacare)

On Thursday, the U.S. Supreme Court ruled to uphold the Patient Protection and Affordable Care Act enacted by Congress in 2010. The only provision that was struck down was the federal government’s ability to coerce states to expand their Medicare program to help cover the poor.

Mental health care will benefit much like regular health care under the new law.

Under the provisions of the new law, people with low income and who cannot currently afford insurance will also have greater access to an expanded version of Medicaid, the federal/state program for the poor and disabled. It’s expected that eventually the new law will help 30 million more Americans enjoy health care coverage.

Although many of the law’s provisions will take years to fully implement, this is Psych Central’s analysis of the Affordable Care Act, as it pertains to mental health care:

• Mental health care will become more accessible to more people.With the passage of the federal mental health parity law a few years ago, many (but not all) insurers were required to treat mental disorders with the same coverage limits as any other disease or health concern. While this has helped many people obtain needed treatment without having to jump through as many insurance company hoops, it hasn’t really mattered much to the poor — who didn’t have insurance coverage in the first place.

  With more people obtaining either private insurance or joining an expanded Medicaid program, the bet is that more people who have inexpensive access to mental health treatment.

• People won’t be denied coverage based upon their pre-existing condition.This is huge for many people with mental health concerns. Changing employers or insurance providers often meant having to pretend that a pre-existing psychiatric diagnosis didn’t exist. The new law says that you can’t discriminate against a person because of a pre-existing condition. This means that more people will get the care they need and have it covered by their insurance plan.

  It also means an insurance plan can’t cancel your coverage for a pre-existing condition, something that was problematic for many in the past.

• People will get better overall care.The law is designed to help increase incentives to physicians and other health and mental health professionals to look after people across the entire continuum of care — holistically, not just Patient X presenting with Z symptoms. It’s also focused on preventative care, which can help keep a person out of the hospital.

  Research suggests that this sort of integrated, coordinated care is ultimately beneficial to the patient. It can help catch health issues before they become more serious concerns. It can also ensure that if a person gets a life-threatening diagnosis, they’re also seen by a professional for their emotional health needs.

• Medication coverage gap in Medicare remains filled.If you’re a senior and enrolled in Medicare, the law has already helped save on your prescriptions. With the high cost of many psychiatric prescriptions, the law helped cut the amount a person pays for their name-brand drugs by half when they were in the “donut hole” (between $2,930 and $4,700 in total prescription costs).

  This helps to ensure that seniors who need their psychiatric medications can continue to afford to take them.

Much of the law will be implemented in pieces over the next five to 10 years, but some components of the law are already in place. These components include insurance companies being forbidden to put a lifetime limit on the amount of health care dollars they spend on any single individual, and insurance companies being forbidden to deny coverage to children with pre-existing conditions.