Whether the new health reform law achieves its goals of accessible and affordable care will depend upon implementation at the state and federal level. That is especially true with respect to the establishment of state-based exchanges and the expansion of Medicaid.
The exchanges are important for a number of reasons. Policies that are sold through them will provide mental health and addiction treatment to individuals who would otherwise be forced to go without coverage. The exchanges as well as the Medicaid expansion provision will also provide health insurance coverage to up to 32 million Americans, including many of the __% of individuals in STATE who are uninsured (you can find the percentage of uninsured in your state here).
The establishment of the exchanges, which are to be operational by 2014, will provide a marketplace for individuals and small businesses who are currently unable or struggling to purchase health insurance. The exchanges will pool risk and thus offer lower premiums than previously available.
There is much work to do to establish the exchanges and MHA of _______ has offered to assist with implementation and looks forward to working with the state insurance commissioner (or other appropriate governing body) to be ready for 2014.
Under the law, Medicaid will expand in 2014 to 133 % of the federal poverty level regardless of the traditional eligibility categories. That allows childless adults who make $14,404 per year or families of four with an income of $29,327 to have access to public health insurance they would not have been able to afford otherwise. This expansion will not significantly add to the state's healthcare costs, as those newly eligible for Medicaid will be covered entirely by federal funding, phasing down to 90% federal by 2020.
For the behavioral health community, perhaps the most exciting provisions include the parity requirements in both the exchanges and the Medicaid expansion. Mental health care and addiction treatment are included on the list of essential benefits that must be covered in new plans offered through the exchanges. These benefits (and others on essential list including rehabilitative services, prescription drugs, preventive services, etc) are being defined by the Secretary of Health and Human Services, and Mental Health America is working with her office to ensure a meaningful behavioral health benefit. Additionally, ACA includes a mandate that the mental health and substance use benefits that are required of plans offered through the Exchanges will apply to the newly eligible Medicaid beneficiaries. ACA clearly recognizes the importance of prevention and treatment of mental health and addiction and the need to integrate mental and general health.
MHA stands ready to provide assistance and consultation for appropriate and timely implementation of ACA and encourages the Governor and legislature to continue to move forward with implementation of ACA.
Together we have a historical opportunity to ensure that all individuals living in STATE, especially those living with mental health and substance use conditions, are able to have access to adequate and affordable health coverage. We must now take advantage of the opportunity before us.
__________is the CEO of Mental Health America of _________.