What the Affordable Care Act Means to Mental Health
With the Supreme Court ruling that the Patient Protection and Affordable Care Act — enacted by Congress in 2010 — can stand, it paves the way for full implementation of the law in the years to come.
There are many benefits to the law. For instance, eventually an insurer won’t be able to turn you down for a pre-existing psychiatric or health condition (kids are already covered by this provision; adults soon will be). Low-income people will also have greater access to an expanded version of Medicaid, the federal/state program for the poor and disabled.
Opponents of the law suggest it will drive up health-care costs — something the law wasn’t intended to fully address. Health care costs are already rising much faster than inflation, so this is an ongoing problem that most economists, politicians and physicians can find little agreement on how to solve. The Affordable Care Act is meant as a first step in controlling costs, however, by emphasizing preventative care and cooperative, integrated physician/hospital practices.
What does the Supreme Court ruling mean for access to mental health treatment and care in the years to come?
Nobody can predict with certainty the fallout in the years to come from the full implementation of the Affordable Care Act. But here are some of our predictions:
- 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.
The law, which will eventually expand coverage to 30 million Americans without insurance, will be implemented in pieces over the next five to 10 years. 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.
Overall, the Affordable Care Act will benefit mental health care, providing greater access to covered treatment options, including psychotherapy and medications.
Grohol, J. (2018). What the Affordable Care Act Means to Mental Health. Psych Central. Retrieved on June 3, 2020, from https://psychcentral.com/blog/what-the-affordable-care-act-means-to-mental-health/