Mental Health America of WI

Mental Health America of WI

The Promise of Health Care Reform for People with Mental Health and

Substance Use Disorders

***********************Shel Gross, MPA

Director of Public Policy

The Bottom Line

We’ve been asking to be treated as first class citizens;

ACA does that.

-National Council webinar

Private Insurance Regulation

• No pre-existing condition

exclusions

• Guaranteed issue

• Premiums can’t be based on health status

• Plans offered on exchanges must include MH/SA benefits at parity

Integration

Growing recognition that we can’t bend the cost curve without addressing

chronic health conditions

And

We can’t address chronic health conditions without addressing mental

health

Integration

• State option for “health homes” for people with SMI; 90% federal funding for 2 years.

• Post-partum depression campaign.

• Centers for Excellence on Depression.

• Prevention services at no cost include depression and substance use screening.

Medicaid/Exchanges

• Allows expansion of Medicaid to 133% FPL with enhanced federal funding.

• Allows Medicaid to cover non-disabled adults without dependent children.

• Along with formation of

exchanges can reduce the

uninsured by more than half.

Largest share of Expansion Pop. Are ‘Childless Adults’

Prevalence of Behavioral Health Conditions Among Uninsured Adults Ages 18-64 with Incomes <400% FPL

MH/SA Prevalence in the Medicaid Expansion Pop.

SAMHSA Data: see citation

MH/SA Prevalence in the Exchange Population

Will the Promise Be Realized?

Status of Medicaid Expansion

• 27 states currently not moving forward or still debating Medicaid expansion.

• If they don’t expand an estimated 6.4 million fewer people would gain coverage.

• This represents nearly two-thirds of the potential reduction in the uninsured tied to the expansion.

Analysis prepared by the Urban Institute for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured

Status of Medicaid Expansion

State Status

Illinois Expanded to 133%

Indiana Build on Healthy Indiana Plan waiver?

Michigan Legislature debating as we speak; not expansion but

movement

Ohio Gov. and Leg. at odds; may “extend” MA

Wisconsin Childless adults to 100%; MA contraction for parents

Status of Exchanges

Outreach Challenge

• Even in States with expanded coverage, research has shown that individuals with MH or SU conditions remain disproportionately likely to be uninsured.

• According to Massachusetts Bureau of SA Services 20-25% of acute service presentations (primarily detox) are uninsured. These are disproportionately young men who are otherwise physically healthy.

Citations

• MH/SA Prevalence Data: 2008-2011 National Survey of Drug Use and Health; 2011 American Community Survey.

• State Exchange Map: National Academy of State Health Policy.

Contact Info

Shel Gross

Mental Health America of WI

608-250-4368

[email protected]