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The Affordable Care Act, "Obamacare"

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

 The Affordable Care Act, “ObamaCare”

Case:

“She is recently divorced and is now the single parent of a 2 year old child. Her ex husband is unemployed and has no health insurance coverage. She works part time and cannot afford health insurance for herself and her child. As a result, she has no insurance coverage for the mental health services she uses to help her deal with depression and stress following her divorce. Feeling desperate, she does not know what to do. Part of the answer may be in what is about to happen under the new health law about to go into effect.”

One of the most important areas of the Affordable Care Act, also known as Obamacare, is in providing mental health services for people who currently do not have it available. In fact, in combination with the Mental Health Parity Act, it should make mental health services more available people through insurance reimbursement. In part, the act reads this way:

*1. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.
2. MHPAEA applies to plans sponsored by private and public sector employers with more than 50 employees, including self-insured as well as fully insured arrangements. MHPAEA also applies to health insurance issuers who sell coverage to employers with more than 50 employees.

*This comes from the Department of Labor and can be found at:
http://www.dol.gov/ebsa/mentalhealthparity/

Thus far, there have been difficulties implementing this law because insurance companies have found loop holes that, in effect, undermine the intention of the law. Nevertheless, it is hoped that with Obamacare, mental health affordable care for mental health will be made available to more people. 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.

In addition, The Affordable Care Act will ensure that psychiatric medications will be affordable, especially under Medicare. This is especially true for senior citizens who are on Medicare and who have mental health problems. Also, people with pre-existing mental illnesses cannot be denied reimbursement for mental health services.

Because mental illness is often seen as separate and apart from overall health, a provision of Obamacare will  make it easier for the health system to view patients in the entirety. This will meant coordination of services so that psychiatrists and other medical personnel can work together in treating those with mental illnesses.

To learn more or to sign up for the Affordable Care Act, go to the following website:

http://www.healthcare.gov

Allan N. Schwartz, PhD

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