The Affordable Care Act (ACA) of 2010, also commonly referred to as Obamacare, can be termed as the most progressive and inclusive piece of healthcare legislation ever to be implemented by the American federal government since the institutionalization of the Medicare and Medicaid programs in 1965. During its infancy years, the ACA has been effective in cushioning uninsured Americans from catastrophic medical expenses by increasing the access, quality, and affordability of health insurance (Martin, 2015). Owing to the fact that most individuals with mental health and substance abuse conditions were previously uninsured, it follows that they stand to gain immensely from the passage of the ACA. This paper attempts to shed light on the implications of the ACA for mental health conditions and substance abuse.
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Implications of Act for Mental Health Illness & Substance Abuse
Prior to the passage of the Act on March 30, 2010, most American healthcare insurers were known to deny insurance coverage to individuals with particular health burdens such as mental illness and substance addiction. However, these individuals are now included in the mainstream healthcare system as the Act “prohibits insurers from denying coverage to individuals regardless of pre-existing conditions” (Martin, 2015, p. 408). Such a shift is of immense importance to many people who were previously debarred from the private market, including those who could not secure services for known health challenges such as mental sickness and substance abuse (Golden & Vail, 2014).
In addition to prohibiting insurers from denying coverage to specific groups of the population, it can be argued that the Act has made it possible for individuals with depression, anxiety, cognitive impairment, substance abuse problems and other disorders to enjoy expanding insurance coverage through Health Insurance Exchanges (HIE) and state-specific Medicaid expansions (Golden & Vail, 2014). These individuals were previously not eligible for Medicare, implying that the ACA has contributed substantially in terms of enhancing mental health coverage and access to care.
Furthermore, it has been documented that most private insurers are now obligated by regulations and guidelines contained in the Act to provide a multiplicity of free preventive services without charging copayment or coinsurance to the actual users (Golden & Vail, 2014; McMorrow, Kenney, & Goin, 2014). Such an arrangement offers immense benefits to individuals with mental health and substance abuse problems owing to the fact that most of them are not economically capable of paying for the services. Available literature demonstrates that “the two covered services most relevant to mental health care are alcohol misuse screenings and counseling and depression screenings” (Golden & Vail, 2014, p. 97). The bottom line is that the Act has implemented mechanisms aimed at triggering the recovery of these individuals through providing a framework for free preventive services to become a reality.
Lastly, the ACA has been influential in expanding the Mental Health Parity and Addiction Equity Act (MHPAE) of 2008 by “identifying mental health and substance use treatment as one of the ten essential health benefits for all health insurance plans in the individual and employer market – inside and outside HIEs” (Golden & Vail, 2014, p. 97). This expansion means that the ACA now mandates mental health and substance abuse treatment coverage for vulnerable populations (Siegwarth & Koyanagi, 2011) and that insurance plans must be consistent across treatment protocols for physical and mental conditions affecting specific groups of the American population (Golden & Vail, 2014).
From the discussion, it is clear that individuals with mental health and substance abuse problems stand to benefit from a whole range of interventions made possible by the implementation of the ACA. It can therefore be concluded that that the ACA provides the United States with a momentous opportunity to change a disjointed and deficient healthcare delivery system, particularly when it comes to addressing the needs of individuals with mental health and substance addiction challenges.
Golden, R.L., & Vail, M.R. (2014). The implications of the Affordable Care Act for mental health care. Generations: Journal of the American Society on Aging, 38(3), 96-103.
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Martin, E.J. (2015). Healthcare policy legislation and administration: Patient Protection and Affordable Care Act of 2010. Journal of Health & Human Services Administration, 37(4), 339-358.
McMorrow, S., Kenney, G.M., & Goin, D. (2014). Determinants of receipt of recommended preventive services: Implications for the Affordable Care Act. American Journal of Public Health, 104(12), 2392-2399.
Siegwarth, A.A.W., & Koyanagi, C. (2011). The new heath care reform act and Medicaid: New opportunities for psychiatric rehabilitation. Psychiatric Rehabilitation Journal, 34(4), 277-284.