Thirty-two million people stand to gain new or expanded access to mental health services as a result of a recent federal ruling that requires most health insurance plans to cover treatment of mental health illnesses, behavioral disorders, drug addiction and alcohol abuse. The rule will take effect in 2014, under the full implementation of the Affordable Care Act [Obamacare].
According to the White House, the rule is a major expansion of coverage. According to the New York Times, “In the past, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.”
The new ruling is part of the revised definition of “essential services” that must be offered by health insurance plans starting in 2014. Kathleen Sebelius, the Obama administration’s secretary of health and human services, said standardizing benefits would make it easier for consumers to compare health plans. ”
…Policies can be offered at four levels of coverage. Under the least generous policies, known as bronze plans, consumers will pay 40 percent of the costs of covered benefits, on average, and insurers will pay the rest. Under the most generous policies, known as platinum plans, consumers will pay 10 percent. The administration, however, declined to set a uniform national standard and allowed states to set many of the specific requirements.
Minimum benefits will vary from state to state, as each state will have a benchmark plan, reflecting coverage typically offered by employers. In more than 30 states, the benchmark, or standard, is an insurance plan offered by Blue Cross and Blue Shield.
Insurers in each state will generally be required to provide all benefits required by state laws adopted before Dec. 31, 2011. States can require additional benefits, but will have to pay the extra costs themselves.
More broadly, the new ruling brings America one step closer to mental-health parity, whereby insurers would be prohibited for charging higher premiums for policies that include mental health coverage. Mental health providers and advocacy groups have sought mental-health parity for years. Could we be inching toward that enlightened direction at long last?
In any event, it could be hard for anti-Obamacare zealots to argue against this new ruling. Opponents of Obamacare who are also staunch gun-rights advocates have taken to claiming that they want to keep guns out of the hands of people with mental illness. Expanding access to mental health care would seem, then, to be right up their alleys. Let’s see what happens next.
Gloria Shur Bilchik is a freelance writer and community volunteer in St. Louis, Missouri. She is the editor of Occasional Planet. She views the preservation of progressive values as vital to making the US a humane, livable place for her children and grandchildren.