Up to 10.5% of the 32 million uninsured Americans who will receive coverage under the Affordable Care Act have preexisting mental health or substance use conditions, Ron Manderscheid, Ph.D., said in a teleconference sponsored by the Substance Abuse and Mental Health Services Administration.
The expanded coverage these consumers will receive is sure to have ripple effects throughout the health care system -- ultimately saving lives, said Dr. Manderscheid, executive director of the National Association of County and Behavioral Health and Developmental Disability Directors. He added that under the current health system, public mental health clients die 25 years sooner than the average American because of a lack of access to primary care.
Carol McDaid said there is much to be gained from the new law. "As recovery advocates, we are going to continue to make sure that the law is implemented and enforced according to congressional intent," said Ms. McDaid, cofounder and principal of Capitol Decisions, a nonprofit advocacy organization. She added that providers who choose to participate with the state-based health insurance exchanges will be required to offer mental health and addiction services.
Many aspects of the health care reform law will not go into effect until 2014, but consumers already can benefit from restrictions against insurers limiting annual and lifetime coverage, coverage for young adults who are on their parents’ plan (through age 26), coverage regardless of preexisting conditions, and an external review process for denied claims, Ms. McDaid said.
This access to essential health benefits, including treatment and rehabilitation for mental health and substance use disorders, is a first for behavioral health, said Alice Dembner, deputy police director for Community Catalyst, a nonprofit advocacy organization. The health exchanges, one of the offerings that will go into effect in a few years, will include premium and cost-sharing subsidies for low- and moderate-income people. This will provide assistance to thousands of mental health patients, Ms. Dembner said.
Despite the Affordable Care Act’s potential benefits to those with mental illness, the new law could be undermined by several factors, Ms. Dembner said. Those factors include the federal debt ceiling, which limits the government’s ability to borrow money to fund spending; state court cases challenging the law’s constitutionality; and the 2012 electoral campaign, in which candidates vying for the Republican nomination will campaign against the law.
Most of the Affordable Care Act’s provisions will roll out in the future, a factor that seems to be working to the advantage of its opponents. "So there is a long time lag there for the potential for erosion of political will, and there’s still limited public understanding of the law and what it will mean," Ms. Dembner said, adding that public awareness and support are critical to preserving the law.