Will you Treat ME?

Funding Mental Health Care Treatment Now and Under the Affordable Health Care Act

Jayme Xaris / Jayme NelsonAssociate Professor of Nursing

Luther COllege

Sketch of a shackled inmate at London's Bethlem Royal Hospital, known as Bedlam. Photograph: Time & Life Pictures/Getty

Health Expenditure as a Share of GDP in 2010

Organization for Economic Cooperation and Development (OECD)

Health Spending Per Capita by Category of Care

Source: WHO

Mental Health Expenditures by Type of Service in 2005

OutpatientInpatient

ResidentialPrescription

Drugs

0

5

10

15

20

25

30

35

Expenditure

Expenditure

Mental Health Care Justice?

Senator Paul Wellstone Addressing a DC Crowd About Mental Health Parity

How will the Affordable Care Act Impact Mental Health Care Coverage?

• Access, Access, Access….• Extension of coverage of dependents to age

26• Abolishment of pre-existing conditions• Creation of health insurance exchanges– Language that you will be able to understand– Exchange must cover mental health services and

substance disorder services

Center on Budget and Policy Priorities http://www.cbpp.org/cms/index.cfm?fa=view&id=3819

Medicaid Expansion – April 21, 2013

ACA and Mental Health Parity Act

• This combination provides powerful mental health coverage to millions of Americans– Mental health care and substance abuse part of

10 essential services– Mental Health Parity Act requires that services be

on par with all other services

Affordable Care Act

• Additional innovative options for those with mental health conditions– Community First Choice Option– Health Homes

Why should we care about mental health parity?

• Growing research indicates a physiologic component to mental health illness

• Mental health related fatalities exceed those of HIV/AIDS

• Increased costs would most likely be offset by increased worker productivity and decreased utilization of other costs (general medical service utilization)

Artist:Igor Morski

References

• Krisberg, K. (2012). Health Law Raising U.S. Mental Health Parity to the Next Level. The Nation’s Health. Sept. 2012.

• Mauldin, J. (2011). All Smoke and No Fire? Analyzing the Potential Effects of the Mental Health Parity and Addiction Equity Act of 2008. Law and Psychology Review 35; 193-207.

• Mechanic, D. (2011). Behavioral Health and Health Care Reform. Journal of Health Politics, Policy & Law 36 (3): 527-531.

References

• Siegwarth, A. & Koyanagi, C. (2011). The New Health Care Reform Act and Medicaid: New Opportunities for Psychiatric Rehabilitation. Psychiatric Rehabilitation Journal 34 (4); 277-284.

• Smith, D., Lee, D. & Davidson, L. (2010). Health Care Equality and Parity for Treatment of Addictive Disease. Journal of Psychoactive Drugs 42 (2); 121-126.

Helpful Websites

• http://www.healthcare.gov/law/• http://www.healthcare.gov/using-insurance/l

ow-cost-care/medicaid/• http://www.cbpp.org/cms/index.cfm?fa=view

&id=3819• http://www.oecd.org/

Thank you!

• Questions? Please don’t hesitate to contact me –

• Jayme Xaris in Second Life• Jayme Nelson in Real Life – nelsjaym@luther.edu