Monday, March 23, 2015

APA Fights for Mental Health Parity as ACA Marks Fifth Anniversary

On the fifth anniversary of the signing of the Affordable Care Act (ACA), APA continues working to ensure that the promise of the reform law—which mandates mental health and substance use service as an essential health benefit and compliance with the federal parity law in newly formed health exchanges—is realized.

In a statement released today, five years after he signed the watershed legislation into law, President Obama said the ACA is working.

“After five years of the Affordable Care Act, more than 16 million uninsured Americans have gained the security of health insurance—an achievement that has cut the ranks of the uninsured by nearly one third,” Obama said. “These aren’t just numbers. Because of this law, there are parents who can finally afford to take their kids to the doctor. There are families who no longer risk losing their home or savings just because someone gets sick. ... There are Americans who, without this law, would not be alive today.”

But the ACA faces a potentially fateful Supreme Court challenge to certain provisions of the law. And a recent study in Psychiatric Services found inconsistencies with the federal parity law in the benefits summaries for mental health and substance abuse services of health plans in two state-run health exchanges. Those inconsistencies—in quantifiable treatment limits (cost-sharing, deductibles, treatment limits) and nonquantifiable treatment limits (prior authorization and other strategies for restricting treatment use)—may either reflect actual no-compliance with the law or an effort by plans to dissuade potential consumers who expect to use mental health services from enrolling in a plan.

APA is pursuing a multifaceted strategy of education and advocacy, as well as legal action against companies that fail to comply with the law. As part of that strategy, APA created the Mental Health Parity Poster and is encouraging psychiatrists and other mental health clinicians to post it in waiting rooms or clinics to educate patients about their legal right to equal treatment. More than 100,000 posters have been distributed, with district branches (DBs) and other associations and hospitals cobranding them. A Spanish-language version is being developed.

For more information, see the Psychiatric Services study "A Tale of Two States: Do Consumers See Mental Health Insurance Parity When Shopping on State Exchanges?“ See also the "Employer Guide for Compliance With the Mental Health Parity and Addiction Equity Act," developed by the American Psychiatric Foundation and its Partnership for Workplace Mental Health.


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