ACA Implications in Mental Health
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2011 Virginia Rural Health Summit presentation
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ACA Implications in Mental Health
- 1. The Affordable Care Act, Behavioral Health and Implications For Rural Communities William J. Hudock Senior Public Health Advisor Substance Use and Mental Health Services Administration
- 9. What Do We Know About the Newly Covered? Source: Center on Budget and Policy Priorities Traits <100% FPL 100-200% >200% FPL Poor or fair physical health 25% 18% 11% Poor or fair mental health 16% 11% 6%
- 15. Elements of Expanded Coverage 1/1/2014
- 16. Timelines for Provisions of Interest * =authorized but not yet funded 2010
Editor's Notes
- The biggest change created under the Affordable Care Act is the expansion of health insurance coverage to almost all Americans. This is accomplished through several interrelated initiatives: The first is a mandate that all Americans have credible health insurance coverage. While there are provisions for those who for religious reasons cannot participate, this mandate applies to virtually all citizens and legal residents. To make this mandate affordable, the law provides for premium subsidies for all individuals and families who earn less than 400% of the federal poverty level or $44,300 for an individual and $88,000 for a family of four. These subsidies are set on a sliding scale to make coverage affordable. Medicaid eligibility is set at 133% of the federal poverty level or $14,400 for an individual and $28,000 for a family of four. Importantly, eligibility restrictions that have excluded men and childless women in many states are removed. Through these changes Medicaid enrollment is expected to increase from 34 to 50 million. The federal government will pay 100% of the cost for newly eligible individuals from 2014 through 2016. The reimbursement rate to states declines to 95% in 2017 and gradually is reduced to 90% after 2019. The law establishes state insurance exchanges through which individuals, small employers and eventually all employers will be able to purchase health insurance.
- On September 23 rd , the 6 month anniversary of the passage of the Affordable Care Act a number of consumer protections provided by the legislation took effect that impact 194 million Americans who have private insurance and anyone planning to buy it. Insurers can no longer deny children coverage for a preexisting condition. Young adults can stay on their parents’ policy until they turn 26. Insurance companies can’t cancel your policy if you get sick, no more lifetime caps on how much insurers will pay, and preventive care, such as cancer screenings, will be covered completely at no cost to you.” small business tax credits, high-risk pools, expanded coverage for adult
- Starting in 2011, seniors who fall into the donut hole will receive a 50% discount on brand-name drugs. The discount for generic drugs will be 7%. Those figures will rise over the years, eventually reaching a total 75% discount that effectively will eliminate the gap in 2020.