Behavioral Health Parity and the Affordable Care Act

Abstract

Prior to the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Patient Protection and Affordable Care Act (ACA), about 49 million Americans were uninsured. Among those with employer-sponsored health insurance, 2% had coverage that entirely excluded mental health benefits and 7% had coverage that entirely excluded substance use treatment benefits. The rates of noncoverage for mental and substance use disorder care in the individual health insurance markets are considerably higher. Private health insurance generally limits the extent of these benefits. The combination of MHPEA and ACA extended overall health insurance coverage to more people and expanded the scope of coverage to include mental health and substance abuse benefits.

KEYWORDS:

• cooccurring disorders
• disability economics
• disability policy
• health care
• mental health
• mental illness
• policy
• substance abuse

Notes

Note that the ACA also prohibits preexisting condition exclusions for all Americans starting in 2014. It requires guaranteed issue and renewability in 2014. It decouples premiums from measures of health status in 2014. Lifetime caps on benefits were prohibited in September 2010 and annual limits are restricted and prohibited in 2014.