Wednesday, 11 July 2012
After the Supreme Court’s landmark decision to uphold Obama’s Affordable Care Act, the political and public reaction overwhelmed newsrooms, but did little to explain how the act hurts or helps Americans. New York Times journalist and MD, Richard Friedman, took a closer look at what the Affordable Care Act actually means for Americans with mental illness, and had some surprising conclusions.
Friedman surmised that the Affordable Care Act has the power to do what the Mental Health Parity and Addiction Equity Acts of 2008 could not – to provide individuals will mental illness and substance abuse with near-universal health insurance, not just for their medical problems, but for their psychiatric disorders too. One of the act’s fundamental tenants is that it forbids the exclusion of people with pre-existing illness from receiving coverage. As Friedman points out, “by definition, a vast majority of adult Americans with a mental illness have a pre-existing disorder… These people have specifically been denied medical coverage by most commercial insurance companies — until now.”
While the individual mandate will help many people with psychiatric disorders get treatment, Friedman cautions that it can also hurt lower income Americans. The Supreme Court ruled that the states can refuse to accept the expansion of Medicaid, which could leave lower income people in “a terrible predicament: They earn too much to qualify for Medicaid, yet not enough to get the federal subsidy to pay for insurance.”
In summary, Friedman states that “the Affordable Care Act is reason to cheer. Americans with mental illness finally have the prize that has eluded patients and clinicians for decades: the recognition that psychiatric illness should be on a par with all other medical disorders, and the near-universal mandate to make that happen.”