Some state exchange health plans limit access to mental health services

Despite the 2008 mental health parity law, some health plans on state exchanges have not yet leveled access to mental health services to equal physical health coverage, according to Kaiser Health News.

Health insurers had until Jan. 1 to comply with the parity law, which says that addiction and mental health treatment decisions and management should be comparable to physical health conditions, according to the article. However, proving violations of the law is difficult because the consumer is required to obtain access to plan documents for both types of care, which are usually handled by different plans.

Although mental health issues are prevalent, limitations such as treatment caps and other types of barriers might exist in health plans. According to the report, some plans aren't clear about which mental health services are covered, so patients would only be notified that a treatment wouldn't be paid for by their insurer after they'd already received it.

According to the article, a report published in November by the advocacy group Mental Health America's November found:

  • The states with the lowest prevalence of mental illness and highest rates of access to care include Massachusetts, Vermont, Maine, North Dakota and Delaware.
  • The states with the highest prevalence of mental illness and least access to care are Arizona, Mississippi, Nevada, Washington and Louisiana.
  • The highest rates of emotional, behavioral or developmental issues among young people occur west of the Appalachian Mountains.
  • In America, 42.5 million adults — about 18 percent — suffer from a mental health issue.
  • About 8.8 million Americans have reported serious thoughts of suicide.
  • Nearly 20 million adults have a substance abuse problem.

Additionally, Americans with mental disorders have the lowest rates of health insurance, according to the article. Al Guida, a Washington-based lobbyist who works on mental health issues with Guide Consulting Services, told the Washington Post, "The vast majority of insurance plans offered on [Patient Protection and] Affordable Care Act federal and state exchanges have close to no transparency, which could lead to abrupt changes in both mental health providers and psychotropic drug regimens, with the potential for serious clinical consequences."

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