Mental & Behavioral Health : ACA Impact

Presentation by Laurie Zelaya

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Source: http://copebehavaioral.net/?p=91

ACA: Affordable Care Act

• Signed into law in 2010 by President Obama (also known as "ObamaCare")
• Contains provisions designed to lower health care costs
• Ensures insurance coverage regardless of pre-existing conditions
• Intends to improve efficiency of health care services 

(Healthinsurance.org, 2015)

Mental & Behavioral Health:

• Are there facets of mental & behavioral health that need improvements in the delivery of quality care?
• What changes are proposed by the ACA that will affect these services?
• Will these changes be an improvement, or cause more difficulty in effective and efficient patient care?

Improvements needed:

• Patients requiring mental and behavioral health care have historically been neglected and stigmatized (Sultz & Young, 2014).
• ​Approximately 1 in 4 American adults is categorized to have a mental disorder, and the cost for care prevents many from seeking treatment (Sultz & Young, 2013).
• Conditions affecting older adults in particular often go untreated as a result of a lack of adequate insurance coverage (Golden & Vail, 2014).

What changes will the ACA bring to Behavioral & Mental Health? 

• New income eligibility limits will allow for more people under 65 to be eligible for Medicaid, to include children through the CHIP program (Sultz & Young, 2014)
• Dependents will now be eligible for coverage until the age of 26 (Beronio, et. al. 2014)
• Those eligible for Medicaid have the option to "opt out" if they choose to do so (Sultz & Young, 2014)
• The new expansion of coverage through the ACA will ensure coverage for over 60 million Americans (Beronio, et. al. 2014)

ACA changes continued:

• Discounts on prescription prices not previously covered for seniors 
• Tax credits for small businesses to help offset cost of insurance packages 

      (HHS.gov, 2010)

Source: http://www.vreehealth.com/articles/bid/347262/Federal-Financial-Incentives-are-Available-to-Help-Improve-Patient-Care-and-Hospitals-Financial-Stability

Advantages of ACA changes:

• More insurance coverage options available
• Many opportunities for free preventative care
• Coverage eligibility for individuals with pre-existing conditions
• Reduction in unnecessary spending in health care
• Focus on improving quality of care vs. volume of care for reimbursing physicians

​(Obama Care Facts, 2015)

Source: http://www.doctorshealthpress.com/brain-function-articles/the-biggest-risk-factors-for-cognitive-impairment-in-older-adults

Challenges of ACA on Mental and Behavioral Health:

• Tax penalty to be imposed upon those who are mandated to obtain insurance and yet do not
• ACA mandated budget cuts for Medicare payments and services, especially hospital costs and home health care
• Tax increases for higher income Medicare recipients

​(Obamcare Facts, 2015)

No health care reform plan is perfect in the sense that every consumer will be completely satisfied. The overall goal of the ACA changes to be implemented in the realms of mental 

and behavioral health are intended to benefit patients in improving access and quality of care. With oversight committees in place, reform can continue to be a fluid process adapting to discovered needs over time.

References

Anderson, Steve. (2015). Affordable Health Care for Families and the Self Employed.                                                              Retrieved from: Healthinsurance.org

Sultz, Harry A. Young, Kristina M. (2014). Health Care USA : Understanding Its Organization and Delivery.

Golden, Robyn L. Vail, Matthew R. (2014). The Implications of the Affordable Care Act for Mental Health

                   Care | American Society on Aging. Retrieved from: http://www.asaging.org/blog/implications -                          affordable-care-act-mental-health-care                                                                                                         Beronio, Kirsten. Gleid, S. Frank, R. (2014). How the Affordable Care Act and mental health parity and                              addiction equity act greatly expand coverage of affordable health care. J Behav Health Serv Res.                      2014 Oct;41(4):410-28. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24833486

Sebulius, Kathleen. (2010). New Help for Seniors Who Fall Into the Median Donut Hole: 50% Discount Starts                    in 2011. Retrieved from: http://www.hhs.gov/healthcare/facts/blog/2010/09/donuthole-                                    50percentdiscount.html

References

​HHS.gov. (2014). Small Business Tax Credits. Retrieved from:                                                                                                                        www.hhs.gov/healthcare/insurance/employers/index.html

Obamacare Facts 2015. (2015) ObamaCare: Pros and Cons of ObamaCare. Retrieved                                                                              from: http://obamacarefacts.com/obamacare-pros-and-cons/