Victory for Mental Health Coverage

Last month’s Supreme Court decision to uphold major provisions of the Affordable Care Act was an important victory for the estimated one in four adults who experience a mental illness in a given year (and the one in two who will suffer from one at some point in their life). By combining an individual mandate for health insurance with parity for coverage of psychiatric illness (i.e., mental illness must be covered in the same manner as other medical problems), the healthcare overhaul “has the potential to change the course of life for psychiatric patients for the better, and in that sense it is both humane and right,” notes Dr. Dilip V. Jeste, President of the American Psychiatric Association.

Some provisions of the Affordable Care Act are particularly helpful for mental health coverage, including: 1. Allowing young adults to remain on their parents’ insurance until age 26; 2. Forbidding denial of insurance coverage due to a pre-existing condition; and 3. Removing lifetime caps on mental health benefits.  According to the National Comorbidity Survey (a large study of mental illness in America) 50% of all serious psychiatric illness in the US will begin before age 14 and 75% by age 25. Early diagnosis and treatment in young teens and adults provides critical window to improve long-term prognosis. Due to this pattern of early onset, the majority of adult Americans suffering from psychiatric illness would be classified as having a “pre-existing condition”, which previously could have resulted in denial of coverage. Lastly, mental health disorders can be chronic diseases with cycles of relapse, even for those receiving treatment. Eliminating annual and lifetime caps on mental health coverage will provide access to treatment throughout the course of one’s illness.

Although the full impact of these changes won’t be felt until 2014, the Affordable Care Act is an important step towards ensuring that all Americans suffering from mental illness, including eating disorders, receive the insurance coverage and care they deserve.

By: Susan Kleiman