ACA and Mental Health Services


The establishment of federal health care reform affects a wide range of health services, as previously unattainable care will be provided to many individuals. Mental health benefits will be expanded under the new health care laws, as mental health is considered one of the 10 essential health benefits required by the Affordable Care Act in any health care plans purchased after the ACA’s implementation.

Funds from the 2011 Realignment Behavioral Health Services Growth Special Account will support a number of programs, including mental health services. Per Gov. Brown’s budget summary on health and human services, “The first priority for growth funds is federal entitlement programs: Medi-Cal Specialty Mental Health, including the Early Periodic Screening, Diagnosis, and Treatment benefit, and Drug Medi-Cal.”

The Dept. of State Hospitals, established in July 2012, will receive $1.6 billion in funding in 2014-15 to provide mental health care, not just to the average patient but also for prison inmates.

The budget summary reads, “California increased the mental health and substance use disorder benefits available through Medi-Cal to provide needed services, including to those who are released from prisons or jails and need these types of services to better support their reentry into the community.”

Mental health care appears to be available like never before but, though the resources are there, it may be too early to accurately gauge the effectiveness of these newly available services.

“The jury is still out,” said Lukas  Alexanian, medical director of Behavioral Medicine at Glendale Adventist Medical Center, who said that reports of the availability of mental health coverage can be misleading.

Alexanian said that depending on a health plan’s reimbursement rate that insurance might not necessarily get someone the treatment they expect, particularly in the case of Medicaid/Medi-Cal.

“Some of these plans are reimbursing the doctors three or four times less than they would with regular patients. Some might find that they can’t see a doctor because that doctor does not want that kind of reimbursement. You could see that as the doctors being ‘greedy’ or that they’re being realistic businessmen,” Alexanian said.

Alexanian also said that the availability of doctors is another issue, with many clinics serving mental health patients being “overwhelmed.”

“I’ve seen many places where the first available appointment with a doctor might not be for a month, month and a half.”

Though Alexanian said the amount of coverage was misleading, he granted that it was not certain whether the ACA would have a negative or positive impact on the state of mental health care and encouraged people to seek help if they need it. Outside of acquiring proper coverage, the stigma of receiving help for mental health issues still persists, another barrier to many getting the help they require.

“Yes, there is a stigma, but it isn’t as bad as it used to be,” said Alexanian. “People are generally attentive about their moods. No one wants to be depressed.”

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