Psych Central


Today’s ruling on what has come to be known as “Obamacare” is extremely good news for those of us with mental illnesses. Discrimination against people with preexisting conditions, whether it is bipolar disorder or cancer, is wrong. Always has been. Always will be.

Insurance companies should be ashamed of themselves for perpetrating this bigotry that has ruined the lives – actually taken the lives – of so many people.

Regardless of whether you watch Fox News or Rachel Maddow, mental illnesses, among the most stigmatized illnesses in our society, can affect anyone. Rich, poor, old, young, male, female, black, white or Hispanic. Clinical depression has become one of the nation’s costliest illnesses, estimated to cost employers tens of billions of dollars every year workplace disability and lost productivity.

Do you know how much medical insurance you could buy with that kind of money? Do you have any idea how much companies could save in lost productivity and sick days if workers with a history of depression had not been denied coverage because of a preexisting condition?

12 Comments to
Why the Supreme Court’s Ruling Matters to the Mentally Ill

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  1. Unfortunately the Obamacare also allows federal tax dollars to be used for abortion. I can’t sacrifice innocent lives for my own health and happiness.

    • Rita, I’m not sure where you heard that, but a wild guess would be the conservative Right who have started do many other rumors and downright untruths about the ACA in order to sway the public’s feelings about it. I DO know for certain, however, that you have not read the law yourself – not least the part about abortion – because if you had, you would know that it absolutely dies NOT. allow ANY federal tax dollars – not one dime – to be used for abortion. I can confidently assure you of that for many reasons; the main one being that I HAVE read the bill, in it’s entirety, and it is very, very clear on that point.

      Please stop spreading harmful misinformation. It is irresponsible to make statements when you have not bothered yo ascertain the actual FACTS for yourself, but instead rely on what you have heard from sources that may also be misinformed at best, and biased or agenda-driven at worst.

    • Without the Affordable Care Act, the loss of innocent lives from the schizophrenia, bipolar disorder, major depression due to lack of health insurance and adequate treatment will continue. My 29 yr old daughter did not ask to be born with bipolar disorder. Without decent health insurance, which I Cobra-ed for several years at a rate of $800/month, I truly believe that she would be dead today. Her life is precious and she, too, is a child of God. I respect your personal views but not at the expense of millions of others who struggle daily with life-threatening neurobiological brain disorders.

  2. The government officials get free health care and guess who pays for it? If they can get free health care that’s efficient, why can’t the rest of us?

  3. Obamacare/SCOTUS decision leaves in place federally mandated discrimination against people with mental illness. As I pointed out with Mary Zdanowicz in this Washington Post op-ed

    “For the most severely mentally ill, private insurance is essentially meaningless. Because of their illnesses, most are indigent, and private insurance is a luxury they cannot afford….Medicaid…covers their care, except for a single exception–inpatient care in psychiatric hospitals. The federal government’s Institution for Mental Diseases (IMD) exclusion prohibits Medicaid from reimbursing for most individuals who need care in a psychiatric hospital. If you have a disease in your heart, liver or any other organ and need treatment in a hospital, Medicaid contributes. But if you have a disease in your brain and need care in a psychiatric hospital, Medicaid does not.”

    The ruling by the Supreme Court does not change this. States will continue to declare mentally ill who are hospitalized ‘well’, and discharge them sicker and quicker into the community while pretending that is humane care. As a result of this, many people with serious mental illness will go shelters, others to jails and prisons, and too many to morgues.

    Health Care reform that leaves out the most seriously mentally ill is a national shame.

    • DJ Jaffe:
      Thanks for the insight. Seems like not-paying for in-patient stays in psych hospitals but paying for hospital stays of those with heart, liver or other organ illnesses violates the federal Mental Health Insurance Parity Law. Maybe it will take a lawsuit to straighten that out.

      • How many more mass murder suicides will it take?

  4. Another existing problem is that an employee who pays good money for or has a job that pays for disability most often has a policy that completely excludes coverage for mental health. Lost workdays for in-patient care or just to handle the cycling of bipolar still threatens continued employment for those who have additional coverage that should take care of mental health issues. The brain is part of the body, and disabling illness is illness, period.

  5. Community Mental Health Centers are supposed to be treating the mental health needs of those who qualify for programs such as Medicaid. Of course having the programs split like this makes it more difficult for someone to navigate the system. And CHMC programs have even worse funding issues than Medicaid. Inpatient mental health care is hard to get through the CHMC, the reimbursement rates are way too low for most high quality units to accept CHMC patients.

    After doing my mental health rotation for nursing school in the only facility in the area that took CHMC, I was scared away from treating my own bipolar because I thought that is how I would end up. With urine soaked furniture and with aides that taunted patients until the patient hid in their room 24/7. It may take a Supreme Court level case to change any of this.

  6. @Reasongal: The parity law does not apply for technical reasons. A law suit can not be started because the federally funded public interest law firms only take cases against delivering treatment, not for it. Additionally, because there are rarely significant damages involving cases of the seriously ill (due to their lack of work history) few pro-bono firms are interested.

  7. How many more mass murder suicides will it take before mental illness is fully included, covered, non discriminating, allows for inpatient hospital care, and will not create future exclusions to medical insurance, and life insurance.

  8. I’ve had anxiety/depression for a long time. I’ve been treated by my psychiatrist now for 3 years. My life is wonderful and I’m making great progress. I own my own small biz but haven’t been able to afford health ins in 6 years. I called several ins companies today to try to get a quote. I’m more successful now and can afford insurance. I was rejected by every one of them after one question….”do you have pre existing conditions?” I finally asked “why am I being rejected bc I depression/anxiety? Isn’t this fairly common?” The answer was a rude tone of “you are a health risk.”
    I got off the phone feeling so embarrassed. Like I have “the plague.” Kinda ruined my day:( looking forward to 2014.

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