Responding to Newtown…

In the aftermath of the Newtown gun shootings, there’s a renewed conversation about mental health–and thus, the work that the Affordable Care Act has done to advance mental health, and provide a platform for the signficant work left to do.

In the New York Times, financial advice columnist Ron Lieber writes about the progress made on mental health issues, and assesses the state of mental health being included in private health coverage:

“In the days after the Newtown, Conn., school shooting, parents and politicians took to the airwaves to make broad-based proclamations about the sorry state of mental health care in America. But a closer look reveals a more nuanced view, with a great deal of recent legislative progress as well as plenty of infuriating coverage gaps…

“For many of the people who do have mental health coverage, there is now a bit more of it at a lower cost than there might have been five years ago, even if mental health insurance over all remains much less generous than it was many years ago when employees did not pay as much out of pocket. That’s because a 2008 federal law requires employers with more than 50 employees that do offer mental health coverage to have no more restrictions than there are for physical injuries or surgery, and no higher costs.
 
“This so-called parity bill now applies to a crucial provision of President Obama’s Affordable Care Act. Insurance plans in the exchanges that will offer health coverage to millions of uninsured individuals starting in 2014 must cover many items and services, including mental health disorders and substance abuse.
 
“The combination of parity and expanded care is crucial, according to Anthony Wright, the executive director of Health Access, a consumer advocacy organization in California. After all, parity doesn’t do much good if the mental health coverage need only be equivalent to a meager health insurance plan that covers very little.”

The inclusion of mental health in the “essential health benefits” in private plans is important, and something California made sure to adopt. But in the Boston Globe, Joshua Green makes the case that it’s all about Medicaid–and how the Affordable Care Act expands and protects Medicaid.

“The linchpin is Medicaid. Though mainly thought of as a safety-net program for the poor, Medicaid provides about half of state mental-health budgets. “Medicaid is hands down the most important source of funding for public mental health services,” says Ron Honberg, the director for policy and legal affairs at the National Alliance on Mental Illness…
 
Anyone moved to act by Adam Lanza’s massacre would probably have a greater near-term impact by pushing states to expand Medicaid coverage rather than lobbying for new gun laws. Newtown provides a vivid, heart-wrenching example of how broader coverage might help prevent future tragedies. Even before the shooting, Nevada’s Republican governor, Brian Sandoval, who opposed Obama’s health law, cited mental health care as a reason why he decided to accept the Medicaid funding.

And unlike new gun restrictions, which will be difficult to get through Congress, Medicaid expansion has already passed into law and requires only public pressure on politicians to have its maximum positive effect.”

To be clear, Green say that gun control efforts aren’t worth doing, but that mental health advocacy and Medicaid should be part of any plan to respond to Newtown. At least the kind of a plan that young people are calling for in this video:

Health Access California promotes quality, affordable health care for all Californians.
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