Obamacare will expand access to mental health care

When my brother, who had severe epilepsy, died of a massive seizure at 32, I needed to see a grief counselor. I had been his primary caretaker, and his death hit me hard.

I was fortunate to have access to workplace insurance that included quality mental health services. It’s a benefit I have come to really appreciate.

But many people don’t have access to such care.

I was thinking about this as I followed news reports on the shooting rampage at the Washington Navy Yard in which 13 people were killed, including the gunman, and several others were injured. Police records and comments from people who knew the gunman, who had served in the Navy as a full-time reservist, indicate that he may have had mental health issues.

Now comes the recovery. At least two workers at the Navy Yard reported that they were standing beside people who were gunned down, one shot in the head. One person said that when he got up from a crouched position, there were bullet holes near the top of the wall. I would ask the question, why not me? And I might need someone to help me deal with the trauma or guilt.

I think about the folks who were working at the Navy Yard or other workplaces who have to deal with the aftermath of such tragedies. And while such incidents are rare, it is likely that you are working with people who are struggling with mental illnesses and need help to handle their condition. They aren’t likely to go on a shooting rampage, but they may drink too much, take illicit drugs or fall into a depression they can’t shake.

Although many large and small group insurance plans include services for some mental health and substance-use illnesses, there are gaps in coverage. About a third of those who are currently covered in the individual market have no coverage for substance-use disorders and nearly 20 percent have no coverage for mental health cases, including outpatient therapy visits and inpatient crisis intervention and stabilization, according to the Department of Health and Human Services.

But starting next year, this will change for many workers.

Under the Affordable Care Act, insurance plans offered in the new marketplaces will have to cover a core set of services called “essential health benefits.” Included on the list of 10 benefits are mental health and substance-use disorder services, which include behavioral health treatment, counseling and psychotherapy. Specifically, as part of what’s considered preventive services, plans will also cover alcohol-misuse screening and counseling, depression screening for adults and for adolescents, domestic and interpersonal violence screening for women, and behavioral assessments for children.

Here are two important points about mental health coverage under Obamacare. First, the coverage for behavioral health services must be generally comparable to coverage for medical and surgical care. Second, plans offered in the marketplace have to cover preventive services without charging customers a copayment or coinsurance even if you haven’t met your yearly deductible. However, the services have to be delivered by a network provider.

The Kaiser Family Foundation noted in a report released this month that benefits will be extended in many cases to cover services typically now excluded, such as mental health. Starting next year, health plans won’t be able to deny coverage or charge you more because of a pre-existing health condition, including a mental illness.

Think this issue doesn’t affect you? Well, take a look at these statistics from www.mentalhealh.gov:

•One in 5 adults has experienced a mental health issue.

•Half of all mental health disorders first show up before a person turns 14. Three-quarters of mental health disorders begin before 24. But less than 20 percent of children and adolescents with mental health problems receive the treatment they need.

•One in 20 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder or major depression.

We are reminded of the seriousness of mental illness when there’s an incident like the one at the Navy Yard. However, this issue should matter to workers and employers more often than just at the time of a tragedy.

Open enrollment in the health insurance marketplace begins Oct. 1. Go to www.healthcare.gov to learn more about the behavioral health services offered.

The Affordable Care Act will provide one of the largest expansions of mental health and substance-use disorder coverage in a generation, the Obama administration says. I hope that by expanding access to mental health coverage, we can get people the help they need and in the most severe situations prevent tragedies that result in the loss of life.

Michelle Singletary: michelle.singletary@washpost.com.

Washington Post Writers Group

More in Herald Business Journal

Tulalips break ground on new Quil Ceda Creek Casino Hotel

A 150-room hotel was added to what is now a $140 million complex expected to open in spring 2019.

For modern women, 98-year-old rejection letters still sting

In a stark new video, female Boeing engineers break the silence about past inopportunity.

Teddy, an English bulldog, models Zentek Clothing’s heat regulating dog jacket. (Ian Terry / The Herald)
Everett clothing company keeps your dog cool and stylish

Zentek uses space-age fabrics to moderate the temperature of pets and now humans.

Providence Hospital in Everett at sunset Monday night. Officials Providence St. Joseph Health Ascension Health reportedly are discussing a merger that would create a chain of hospitals, including Providence Regional Medical Center Everett, plus clinics and medical care centers in 26 states spanning both coasts. (Kevin Clark / The Daily Herald)
Merger would make Providence part of health care behemoth

Providence St. Joseph Health and Ascension Health are said to be talking. Swedish would also be affected.

Boeing raises dividend 20%, continues stock buyback program

The manufacturer said it has repurchased $9.2 billion worth of its shares this year.

Trudeau snubs Boeing, unveils plan to buy used Aussie jets

Trudeau will be assessing the impact fighter jet contracts have on his country’s economy.

Everett engineers learn lessons from Mexico City catastrophe

Structural scientists went to help after the September earthquake there and studied the damage.

Value Village sues Washington attorney general over demands

The company said the AG wanted it to tell customers how much of their prices goes to charities.

Study: Almost 45 million tons of e-waste discarded last year

The gold, silver, copper and other materials would’ve been worth $55 billion had they been recovered.

Most Read