Mental health advocates fear the looming death of the Affordable Care Act means losing hard-fought ground on expanding access to treatment for mental illness.
Many view the ACA—which includes mental health services and treatment for substance abuse as required benefits for health plans—as the most significant of three legislative pillars of that progress.
“This is another reason why the immediate repeal of the Affordable Care Act creates a cascade of unintended consequences that are not going to be acceptable to the vast majority of people,” said Paul Gionfriddo, president and CEO of Mental Health America.
Nearly nine years ago Congress adopted legislation intended to impose parity in health coverage for mental health services. The Obama administration implemented the law in 2013 with final regulations that required health plans to have the same deductibles, cost-sharing and coverage limits for mental health services as offered for medical and surgical services.
Congress added more protections late last year in the 21st Century Cures Act, signed by President Barack Obama in December. The law includes tougher enforcement of parity requirements and calls for HHS to help health plans comply.
Both the 2008 Mental Health Parity Equity Act and the 21st Century Cures Act won bipartisan support. But the effectiveness of both laws would be severely hindered by ACA repeal.
“The irony is you can have a decent parity law, which we do, the oversight of the 21st Century Cures Act, but if you take out the Affordable Care Act's essential benefits provision, then you could effectively gut it without even intending to,” Gionfriddo said. “Somebody who casts a repeal vote without coming up with an alternative that's going to be inclusive of people with mental health issues would be doing a lot to undermine this new legislation.”