How Will the Affordable Care Act Affect Me?
I have read into it, not enough to make me an expert, but enough that an English BA graduate would be able to understand what’s going on.
Truth be told, it’s not as easy as a quick textbook read.
According to Barlas (2013), by next year, patients will have purchased new individual and small-group health plans on the state exchanges mandated by the Affordable Care Act.
This is where the book doesn’t close. Mental health benefits will differ from state to state, and it’s hard to know whether they will meet the requirements of the Mental Health Parity and Addiction Equity Act of 2008.
To make it even more confusing, important issues such as network adequacy (or psychiatrist coverage) are still up in the air, along with physician payment rates.
The issue? Regardless of the illness we have,
60 to 70 million people in the US could be impacted by the new health care law, and most of us still don’t know what that means.
In February 2013, the US Department of Health and Human Services issued a final rule that outlines the essential health benefits (EHBs) that all qualified health plans (QHPs) must cover. The EHBs fall into 10 categories, with two being of prime importance to mental health patients:
- Mental Health and Substance Use Disorder Services, Including Behavioral Health Treatment
- Prescription Drugs
Almost all 50 states and the District of Columbia have chosen “benchmark plans.” These are very general with regard to the mental health category.
Barlas says that the small-group plan, which is the benchmark plan in most states, still typically has less generous mental health benefits than employer plans.
Stakeholders in California, for example, are worried about what is set to be minimal mental health benefits in their benchmark small-group plan.
All states have the option of supplementing mental health services in addition to the benchmark health plans in place.
The problem? They will not get any federal assistance to do so.
States’ approaches to the new way of thinking about health care in America are diverse.
Some proponents of better mental health care in the US are concerned about the way the new laws are laid out for the States’ taking.
Bottom line: The flexibility could affect mental health consumers’ ability to make fair comparisons among plans. It could also give us the problem we currently have—the ability for states to design plans that allow them to essentially cherry-pick healthier enrollees.
If you really break it down, is there really all this need for the uproar about socialism and these new laws killing the American way?
I do not have health insurance—the small company I work for currently does not offer it and my husband’s insurance at work is so expensive we cannot afford it. It’s almost as expensive as our rent.
In addition, I cannot get private health insurance because of bipolar disorder. So around I go, hoping I don’t get sick, using Patient Assistance plans and relying on the good graces of my psychiatrist.
Let’s not all get too excited nor too incensed when we hear the words “Affordable Care Act”.
I am still worried about my future as a mental health consumer, regardless of what legislation has been passed.
What do you know about the new health care law? What do you think about it? Do you currently have sufficient access to health care? Do you think the Affordable Care Act will change your current situation?
Barlas, S. (2013, 05 08). Update on mental health benefits and substance use disorder services under the Affordable Care Act. Retrieved from http://www.psychiatrictimes.com/display/article/10168/2141641
Dawkins, K. (2013). How Will the Affordable Care Act Affect Me?. Psych Central. Retrieved on January 17, 2017, from http://blogs.psychcentral.com/bipolar-life/2013/05/how-will-the-affordable-care-act-affect-me/