Patients Face Barriers to Mental Health Care, Despite ACA, Parity Laws
U.S. residents still might have trouble accessing mental health care, despite expanded health care coverage under the Affordable Care Act and mental health parity requirements, according to a report from Mental Health America, the Washington Post reports (Gillespie, Washington Post, 1/5).
Under the 2008 Medicare Improvements for Patients and Providers Act, Medicare was required to cover an increasingly larger portion of the cost of outpatient mental health services beginning in 2010. In 2008, Medicare covered 50% of the cost of such treatment, which increased to 65% in 2013. As of Jan. 1, 2014, Medicare was required to pay 80% of the cost of mental health services, bringing coverage for those services in line with most medical services (California Healthline, 1/2/14).
Exchange Plans Lag on Mental Health Coverage, Report Finds
The report found that despite the 2008 parity law, some health plans sold through state exchanges created under the ACA still do not offer mental health coverage at levels similar to coverage for physical conditions.
For example, the group found that while health plans' "explanation of benefits" might indicate that there are no mental health coverage limits, treatment caps and other barriers could still exist. The report also found that some plans were not clear about what mental health benefits were covered. In addition, the report noted that the U.S. has a shortage of mental health professionals, with one provider for every 790 individuals.
However, the report does not take into account that many health plans use rolling renewals and had until Jan. 1, 2015, to comply with the parity law, according to the Post. According to America's Health Insurance Plans, insurers are complying with the law.
AHIP Vice President of Communications Susan Pisano said, "Our members are committed to mental health parity, and we're supportive of legislation, and what isn't apparent is that benchmark plans represented a snapshot in time ... so that doesn't give us the full picture." She added, "Our plans have really been working to get in compliance."
U.S. Residents Still Struggling With Mental Health Issues
The report also found that:
- 42.5 million adults in the U.S., or about 18%, suffer from a mental health problem;
- 19.7 million, or about 8.5%, have a substance use disorder;
- 8.8 million, or about 4%, have reported seriously considering suicide; and
- The highest rates of behavioral, developmental or emotional issues among young U.S. residents occur west of the Appalachian Mountains, where there are high levels of poverty and social inequality (Washington Post, 1/5).