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The Affordable Care Act and What You Need to Know

Discussion of the Affordable Care Act often incites fear, confusion, and anger in people both for and against its passage. Political commercials claiming “truths” about this act only exponentially worsen the anxiety and irritation. Whether you are in favor of “Obamacare” or not, there may be some important implications of The Affordable Care Act on your mental health treatment that you should be aware of.

On April 3, 2014 Shaindle Braunstein, Supervisor for Michigan Insurance Exchange at Jewish Family Services Mental Detroit spoke to Birmingham Maple Clinic’s advisory board on The Affordable Care Act: Implications for Providers of Behavioral Health Services.  Shaindle explained that the full implementation of the ACA on January 1, 2014 requires that all policies, including group health insurance, must include mental health and substance abuse treatment services. All plans will include coverage for behavioral health services.

Shaindle went on to explain some mental health services that are now considered as “essential benefits” insurances policies must provide according to the ACA. These benefits are the following; required availability of depression screening for both children and adults,  alcohol and substance abuse screening and treatment must be made available to both adults and adolescents, behavioral assessments and counseling must be available to children, and counseling treatment must be covered without limitations on duration or cost of services.

Perhaps the most important change in government policy of insurance companies is the stress on early screening and intervention of mental illness.  According to Ms. Braunstein, the ACA promotes the prevention and early identification of mental health problems, which allows for early intervention and can effectively reduce the burden of these issues on their families and communities. Increased access to key screening services will facilitate improved identification of mental illness at young ages.  Interestingly, according to information provided by Shaindle, children can now begin therapy even without a specific diagnosis. The goal of this change is to reduce the chances that a more serious diagnosis will develop later in life. Families may benefit from improved services such as parent training and coordination with schools and other agencies which have up until now not typically been covered by insurance plans.

Another crucial change provided by the ACA is the integration of mental health care and primary care services. Most people with mental illness do not seek proper treatment for these problems, with the few that actually do seek treatment obtaining care from their family physician rather than a therapist or psychiatrist with specific training. By making health care and mental health care more accessible and affordable the hope is to reduce barriers to seeking care before problems become larger and more expensive.

The ACA will also integrate mental health and substance abuse treatment. The new act encourages the use of preventative services and substance abuse education, evaluation, and treatment and allows therapists treating those with mental illness to pay more attention to SA problems.

If you would like to see a therapist or psychiatrist for any mental health concern such as anxiety, depression, adhd, or substance abuse you can schedule an appointment at Birmingham Maple Clinic by calling (248) 646-6659 or by visiting www.birminghammaple.com. Our talented billing department may assist you with understanding your current insurance benefit and may explain some changes as insurance plans evolve in accordance with the law this year.