Health Care Reform Increases Access to Mental Health

The debate about health care reform was vicious and now that the bill has passed, tempers have subsided and we are left asking ourselves, “how and when will this affect me?” Health care reform will make some helpful changes in access to mental health. Below is a summary of the new changes.

  • Mental Health Parity (January 1, 2010)Under the Wellstone-Domenici Parity Act, insurance companies must provide the same coverage for mental illness and substance abuse as any physical illness. This means they can no longer charge higher co-payments or set lower limits for mental health services than other medical services. Originally, this bill did not apply to employer health plans with less than 50 employees or individual plans. By 2014 it will be expanded to everyone and all insurance plans must offer some mental health coverage.
  • Immediate access to health insurance for people with pre-existing conditions (June 23, 2010)- Coverage will not exclude treatment for pre-existing conditions for eligible individuals. For individuals whose coverage may have been limited due to pre-existing mental health issues, can now be fully covered.
  • Eliminating annual and lifetime benefits (September 23, 2010)- Insurers will be prohibited from imposing annual or lifetime benefits on insurance.
  • Children can no longer be denied insurance due to pre-existing conditions (September 23, 2010)- Children will access to insurance and that insurance will not be limited because of pre-existing conditions, including a mental illness diagnosis. This will apply to all adults in 2014. Currently, a person seeking individual coverage can be denied for being treated for common issues such as depression or anxiety.
  • Creation of National Depression Centers of Excellence (by December 3, 2010)- These centers will specialize in uni-polar and bi-polar depression utilizing evidenced based treatment provided by an interdisciplinary team.
  • Expand Home and Community Based Services (HCBS) to people with disabilities (October 1, 2011)- This expansion will provide more services to those with disabilities, including severe mental illness, in the home and community, reducing the need for institutionalization and increasing independence.
  • Medicaid expansion and financial assistance to purchase private insurance (2014)- Medicaid (Medi-Cal in California) is a federal program that offers insurance to low-income families. The requirements to participate in the program will expand and allow more people to join.

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