The analysis is still percolating, and organizations dedicated to mental health and addiction disorders have been laudatory. Mental Health America's David Shern hailed the "Patient Protection and Affordable Care Act;" Ron Manderscheid, of the National Association of County Behavioral Health and Developmental Disability Directors, said the Healthcare will hold a webinar to discuss "what happens next."
Components of the new law represent major opportunities to promote early intervention and recovery in the mental health community:
•Parity was affirmed and strengthened. Standards guaranteeing access to affordable coverage extend the non-discrimination achievements of parity in mental health and substance use disorders in both the individual and the group market;
•More than 150 million Americans with pre-existing conditions will not be denied coverage. For children this becomes law as soon as the regulations are completed, for others in 2014;
•Mental health is considered a primary comprehensive health service in school based health clinics;
• Funding for community health centers will increase to $11 billion over five years (2011 - 2015);
•Lifetime insurance limits are prohibited, as is the cancellation of insurance policies after the diagnosis of an illness. Each takes effect in 2014;
•Young adults may remain on a parent's policy until the age of 26, a key interlude for young adults struggling with a serious mental illness;
•Medicare loopholes (donut hole) for prescription drugs will close;
•Medicaid coverage for low-income adults is expanded: See the analysis from Kaiser Family Foundation;
•A pilot program for coordinated care known as the Medical Home will provide support for family caregivers, patient self-management, and support for community resources.
Many separate bills introduced in the past year were folded into this reform, including Rep. Patrick Kennedy's bill to increase the number of mental health professionals serving children, the Child Health Care Crisis Relief Act. And Sens. Charles Grassley and Herbert Kohl's Physician Payment Sunshine Act (S 301) to require greater disclosure of drug company payments to physicians.
In saying it was a "leap forward," Kennedy said the historic vote, "marks a new day and a giant leap forward towards our transition from a "sick care" system to one which is preventive, collaborative, and patient-centered.
Pundits have been weighed in. "No longer will the United States be the outlier among wealthy nations in leaving so many of its citizens without basic health coverage," wrote EJ Dionne in the Washington Post. This sentiment is not shared by Republican opponents who have declared a stampede to repeal the new law.