Study: ACA Could Close Mental Health Treatment Gap

Study: ACA Could Close Mental Health Treatment Gap

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 Editor’s Note: Despite the fact that one in six Californians has a mental health issue, private insurers historically have lacked coverage for mental health treatment, and public health programs don’t offer enough, resulting in many patients not getting the treatment they need. The Affordable Care Act could help close the gap, says a study.

A study by the California HealthCare Foundation indicates that about one in 20 adults in California suffers from a serious mental illness, with the rate among children being higher.

Serious mental illness among California adults is highest among Native Americans, multi-racial non-Latinos and African Americans.

There was variation, albeit slighter, in the rates among California children too, with Latino and African American children topping the rate at 8 percent, and Native American coming a close second at 7.9 percent. Rates for white, Asian and multiracial children were close to or below 7 percent.

The study points out that for California children and adults, the prevalence of serious mental illness was higher among those who earned less – statistics borne out by the latest census data, which indicate that the highest rate of poverty is among Native Americans and African Americans.

Overall, one in 10 children below the poverty level suffered from a serious emotional disturbance, the study says. According to the census, about 22 percent of children under 18 lived in poverty last year.

The rate of serious mental illness among children and adults in California varied by region. Among children, it differed slightly, from a high of 8 percent in the San Joaquin Valley and 7.9 percent in the Northern and Sierra region, to a low of 7 percent in the Bay Area.

Among adults, the prevalence of mental illness among adults ranged from a high of 5.3 percent in the San Joaquin Valley to a low of 3.4 percent in the Bay Area.

About half of adults and two-thirds of adolescents with mental health needs did not get treatment, the study said.

When patients seek treatment, they often go through public health programs because private insurers historically provide inadequate care, or none at all because they exclude people with pre-existing illness from coverage. By definition, Americans with a mental illness have a pre-existing disorder.

All that will change, the study pointed out, when the Affordable Care Act (ACA) is fully implemented on Jan. 1, 2014.

Under the ACA, aka Obamacare, health insurers are forbidden from excluding people with pre-existing illness. Health plans offered through Covered California, the state’s online exchange, will include mental health coverage.

California has added a mental health component to its expanded Medi-Cal (California’s Medicaid program for low-income people) that will ensure that its Medi-Cal population with mental disabilities receives more comprehensive mental health benefits—the same, in fact, as people with physical health issues, starting Jan. 1, 2014.

The current mental health component of Medi-Cal is limited in terms of the number of providers and the number of services it offers.

The ACA also encourages a more holistic approach to treatment by promoting greater integration between mental health care and physical health care.

While mental health care providers cheer those changes, they worry whether there will be enough of them to offer treatment to the estimated 125,000 uninsured people who will become eligible for Medi-Cal next year who will need mental health services.