Overview of the Affordable Care Act
What Are the Implications for Behavioral Health?
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA), which seeks to make health insurance coverage more affordable for individuals and families and the owners of small businesses.
When fully implemented, the law will provide access to coverage for an estimated 32 million Americans who are now uninsured. It reforms insurance markets to make them more competitive and protect consumers’ rights by prohibiting such practices as excluding people from coverage due to pre-existing conditions, placing annual or lifetime caps on coverage, banning rescission of coverage, and establishing basic minimum benefit packages.
ACA references a variety of service issues that require discussion and recommendations regarding a set of services that should be available for individuals with mental health and addiction needs. The law will:
- Fundamentally change what services will be available to individuals that have mental health and addiction disorders. Various provisions will require benefit packages that include treatment for mental health and substance use disorder services, prescription drugs, rehabilitative, habilitative, and prevention and wellness services. These services must be available in benefit packages by Fiscal Year (FY) 2014.
- Expand access to prevention services, including annual wellness visits, and include outreach and education campaigns. In addition, grants will be available to implement, evaluate, and disseminate community prevention activities beginning in FY 2010.
- Create additional incentives to coordinate primary care, mental health, and addiction services. In FY 2011, grants and Medicaid reimbursement will be available for the creation of health homes for individuals with chronic health conditions, including mental illness and substance use disorders.
In addition, grants will be available to school-based health centers that will offer mental health and addictions services. Grants may also be available in FY 2011 to programs co-locating primary and specialty care.
- Enhance community-based service options for individuals with a mental health and/or substance use condition. Medicaid state plan changes and demonstration grants will expand these services for individuals who have longterm care needs (e.g., dual-eligibles, high-risk Medicare beneficiaries, 1915i changes, Money Follows the Person). In addition, the CLASS Act* creates a self-funding initiative for individuals who need home- and community-based services. Some of these initiatives begin in FY 2010.
- Develop capacity to provide services in an effective and modern mental health and substance use system through various workforce initiatives, including education and training grants, loan repayment programs, and primary care residency training.
Find out more information about health reform and the Patient Protection and Affordable Care Act at HealthReform.gov.
*Community Living Assistance Services and Supports Act