Good News for Mental Illness in Health Law

NY Times (July 9, 2012)-Americans with mental illness had good reason to celebrate when the Supreme Court upheld President Obama’s Affordable Care Act. The law promises to give them something they have never had before: near-universal health insurance, not just for their medical problems but for psychiatric disorders as well.

Until now, people with mental illness and substance disorders have faced stingy annual and lifetime caps on coverage, higher deductibles or simply no coverage at all.

This was supposed to be fixed in part by the Mental Health Parity and Addiction Equity Act of 2008, which mandated that psychiatric illness be covered just the same as other medical illnesses. But the law applied only to larger employers (50 or more workers) that offered a health plan with benefits for mental health and substance abuse. Since it did not mandate universal psychiatric benefits, it had a limited effect on the disparity between the treatment of psychiatric and nonpsychiatric medical diseases.

Now comes the Affordable Care Act combining parity with the individual mandate for health insurance. As Dr. Dilip V. Jeste, president of the American Psychiatric Association, told me, “This law has the potential to change the course of life for psychiatric patients for the better, and in that sense it is both humane and right.”

To get a sense of the magnitude of the potential benefit, consider that about half of Americans will experience a major psychiatric or substance disorder at some point, according to an authoritative 2005 survey. Yet because of the stigma surrounding mental illness, poor access to care and inadequate insurance coverage, only a fraction of those with mental illness receive treatment.

For example, surveys show that only about 50 percent of Americans with a mood disorder had psychiatric treatment in the past year — leaving the rest at high risk of suicide, to say nothing of the high cost to society in absenteeism and lost productivity. The World Health Organization ranks major depression as the world’s leading cause of disability.

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Health Care Ruling A Win, Disability Advocates Say

Disability Scoop (July 2, 2012)- Advocates are hailing the U.S. Supreme Court’s decision to uphold sweeping changes to the nation’s health care system as a victory for people with disabilities.

The high court ruled Thursday that the nearly all of the Affordable Care Act is constitutional, paving the way for additional provisions of the 2010 law to take effect between now and 2014.

As Democrats applauded the decision, Republicans promptly vowed to repeal the act. Meanwhile, leaders from a host of national organizations representing individuals with developmental disabilities praised the decision.

“People with disabilities and their families have their lives dictated by the status of their health insurance,” said Katy Neas, senior vice president of government relations at Easter Seals. “The Supreme Court’s ruling today tells these families they can make decisions about what is best for them as a family, and not be controlled by fear of losing health insurance coverage.”

President Barack Obama’s signature legislative accomplishment, the health care reform law includes a number of provisions — many of which have yet to be fully implemented — that advocates say are significant for people with disabilities including:

• No more lifetime coverage limits on health insurance plans.
• Insurers will not be allowed to charge higher rates or deny coverage to those with pre-existing conditions, including disabilities.
• Establishes the Community First Choice Option offering states the opportunity to receive increased federal matching funds to support community living.
• Requires health insurance plans to cover a menu of “essential benefits” including mental health services, habilitation and rehabilitation services as well as behavioral health treatment.