Implications for Behavioral Health of the U.S. Supreme Court’s Ruling on Affordable Care Act

IMPLICATIONS FOR BEHAVIORAL HEALTH

By upholding the law, this ruling is a great step forward for behavioral health.  It continues the progress intended by Congress through the passage of the ACA.

 

With this definitive ruling, the federal government and states can now move forward with implementation of key features within the ACA that will bring millions of Americans coverage for mental and addictive disorders.  The reform law, now deemed constitutional, starts to expand behavioral  health coverage well beyond the federal parity law.

 

KEY BEHAVIORAL HEALTH FEATURES OF THE ACA

The ACA has been seen as particularly important for behavioral  health because of a number of provisions expanding mental health and addiction treatment coverage to millions of Americans that don’t now have it.  Specifically, the ACA as written in 2010.

 

  • Extends the federal partiy law to small businesses and individuals inside and outside of the health exchanges.
  • Requires – for the first time in federal law – that the essential benefit package include mental health/substance abuse as 1 of 10 required coverage categories.
  • Expands coverage through Medicaid that would need to include that expanded coverage at parity.

 

The ruling also allows other ACA provisions to move forward, including those that:

 

  • Require quality reporting for inpatient psychiatric facilities paid under the IPF PPS
  • Establish a pay-for-performance pilot program for psychiatric hospitals.
  • Reduce the market basket for psychiatric hospitals and incorporate productivity improvements.

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