Mental Health America Praises House Health Reform Bill

Main Category: Mental Health
Also Included In: Psychology / Psychiatry
Article Date: 06 Nov 2009 - 1:00 PST


Mental Health America today praised the House health reform bill (the Affordable Health Care for Americans Act, H.R. 3962) for taking ground-breaking steps to expand coverage and significantly improving access to mental health and substance use disorder treatment services.

Mental Health America also applauded the legislation for applying mental health and substance use parity requirements to all qualified health benefit plans regardless of whether they are offered in the individual or group market.

"We strongly support this legislation for making important strides in eliminating barriers and expanding access for mental health and substance use services," said David L. Shern, Ph.D., president and CEO of Mental Health America.

[A letter to House Speaker Nancy Pelosi supporting the legislation can be found here. ]

The bill carries forward the principles established in federal law with the enactment last year of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, which prohibits unequal treatment limits and financial requirements for mental health and substance use treatment.

"These provisions are crucial in light of the fact that mental health and addiction treatment have traditionally been subject to blatantly discriminatory limits on coverage that block access to effective and critically needed therapies," Dr. Shern said.

Dr. Shern testified earlier this year before a House Energy and Commerce subcommittee on the need to include mental health and substance use services as part of health reform. (The prepared testimony can be found here. )

He said the bill's the inclusion of mental health and substance use disorder services as well as rehabilitative services as components of the essential benefits package addresses a top priority of Mental Health America in light of recent research showing that a large proportion of low-income, uninsured individuals have poor mental health. Studies also indicate that the current economic turmoil and recession increase the rates of psychiatric symptoms and demand for services.

Mental Health America also strongly supports insurance market reforms in the bill that would establish guaranteed issue and renewal requirements and prohibit pre-existing condition exclusions and premium rating based on health status as well as annual and lifetime limits on benefits. The reforms are important in light of the long history of discrimination against individuals with mental health or substance use conditions.

Dr. Shern said Mental Health America is encouraged by the provision identifying individuals with mental health conditions as a group that should be prioritized in outreach efforts to inform vulnerable populations about the proposed federal programs to increase access to health care coverage.

Mental Health America also pointed to other important provisions that would:

-- Expand Medicaid to all citizens under 150 percent of poverty. Although Medicaid provides comprehensive benefits and support services to millions of individuals with mental health and/or substance use conditions, many do not currently have access to the vital coverage that Medicaid provides. Because of the early age of onset of many mental health conditions and often long delay in treatment, these conditions often interfere with a young person's ability to succeed in school and gain employment and increase the likelihood of developing a costly disability. As a result, many individuals with serious mental health conditions have very low-incomes and would greatly benefit from the provisions in the bill to expand Medicaid.

-- Fill the Part D doughnut hole. Prescription medication is often a key component of effective behavioral health care and the existing gap in Medicare prescription drug coverage called the "doughnut hole" has proven very burdensome for many mental health consumers.

-- Establish a new training program for mental health and substance use disorder treatment professionals. As more individuals with mental health conditions receive health care coverage, it will be important to ensure the availability of behavioral health service providers.

-- Improve access to preventive services. A recent Institute of Medicine report highlighted that there are a number of interventions that have proven effective at preventing mental health and substance use disorders, especially among children and youth. The Prevention and Wellness Trust Fund to support community-based prevention programs and the elimination of cost-sharing for preventive services would improve access to these services and programs. Mental Health America also supports provisions to fund home visitation programs and school-based health clinics. A grant program to help small employers provide workplace wellness programs is another important provision that would incorporate mental health promotion.

-- Improve chronic care management through medical homes and other models. Mental illnesses often accompany and greatly increase the cost of treating other chronic conditions. Research has shown that individuals with diabetes, asthma, heart disease, and obesity who also have a mental health disorder are likely to experience greater functional disability and, in some instances, higher mortality, than individuals whose chronic health conditions are not co-morbid with mental disorders.

Mental Health America also believes that the medical home programs should include behavioral health specialists on the treatment teams established and also that mental health or addiction treatment facilities should be allowed to serve as medical homes.

Mental Health America is urging that the final House bill incorporate an amendment adopted during the House Education and Labor Committee mark-up that would ensure that mental health and substance use disorder screening and brief intervention services would be reimbursable preventative services.

Source
Mental Health America

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