In the past few years, we have made some big strides forward for people with mental illness, and the Affordable Care Act promises more help on the way.
We made some strides in 2008 with the Mental Health Parity and Addiction Equity Act (MHPAEA), which said that health plans that cover mental health services have to provide the same level of coverage as they do for other health services. In other words, if you pay at $25 copay at your primary care doctor's office, you pay the same $25 at your psychiatrist's office . . . if your health plan covers mental health services.
Enter the Affordable Care Act, which brings help. With the new provisions of the law, people with mental health disorders will get help in three key ways. First, the expansion of Medicaid in 2014 to everyone under 133% of the federal poverty level (approximately $26,000 for a family of four) will cover many people with mental illness who currently can't afford insurance. Second, removing pre-existing condition restrictions means that whether you have asthma or depression, insurance companies can't refuse to sell you insurance. Third, Medicaid and insurance plans in the new state exchanges will have to cover 10 categories of essential health benefits, which includes mental health.
Finally, as pointed out in a New England Journal of Medicine Perspectives piece by Colleen L. Barry and Haiden A. Huskamp, the Affordable Care Act will help also by improving integration of services so people don't get lost in the system.
We have a ways to go yet, but the Affordable Care Act makes me hopeful that we are moving to a future where we can make sure that everyone with mental illness can get the help they need.