Mental Health America of WI
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Transcript of Mental Health America of WI
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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
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The Bottom Line
We’ve been asking to be treated as first class citizens;
ACA does that.
-National Council webinar
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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
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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
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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.
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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.
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Largest share of Expansion Pop. Are ‘Childless Adults’
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Prevalence of Behavioral Health Conditions Among Uninsured Adults Ages 18-64 with Incomes <400% FPL
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MH/SA Prevalence in the Medicaid Expansion Pop.
SAMHSA Data: see citation
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MH/SA Prevalence in the Exchange Population
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Will the Promise Be Realized?
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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
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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
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Status of Exchanges
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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.
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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.
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Contact Info
Shel Gross
Mental Health America of WI
608-250-4368