Guest Columns

MARES: TAKING CHARGE OF HEALTH CARE REFORM

ACA expands consumer protections of the Mental Health Parity and Addictions Equity Act

GUEST COLUMNIST

The recent political strife and grandstanding around the Affordable Care Act has largely ignored the issue at the heart of the law: the health and health care of Americans. Every news story that mentions health care reform becomes a possible talking point in a political debate, but those debates rarely rise to the level of finding health policy solutions.

As President and CEO of Mental Health America of Colorado, which for 60 years has been advocating for mental health and transforming systems of care, my perspective on this piece of federal legislation is about health, not politics. We support the continuing implementation of the Affordable Care Act because we have been fighting for health care reform for decades, and now we are taking charge to ensure that it is a vital step on the journey to achieving our vision: A healthy Colorado free of stigma and discrimination, where every person has full access to high quality services for all mental health and substance use disorders.

Health care reform was not born yesterday. Mental Health America of Colorado and our diverse partners from across Colorado have been fighting discrimination against people with mental illnesses, building health care safety nets, and advocating for expanded health coverage since the 1950s. The Affordable Care Act advances these causes through a combination of stronger consumer protections and a market-based approach to expanding health coverage. We have much more work to do, but we must not go back to the way things were before. Let us revisit the reasons why we needed health care reform in the first place.

Prior to the Affordable Care Act, almost 50 million Americans lacked health insurance, and millions more were covered under low-quality plans that could kick them off at any time, had sky-high deductibles, and offered consumers little value for their money. Insurers would not sell their products to millions of uninsured American families because a family member had a “pre-existing condition” like cancer or bipolar disorder. This barrier to affording health care was especially hard on Americans who experience mental health problems, which are by far the most common chronic health conditions in the country. The stigma associated with mental health allowed insurers to treat it as separate from physical health, cover it at lower rates, and even refuse to include it as a part of their plans. Mental Health America of Colorado and our allies across the United States had been fighting this stigma and discrimination for generations, but sometimes it takes action on the scale of national legislation to enable widespread change.

What many opponents of health care reform neglect to point out is that a key element of the Affordable Care Act — strengthening consumer mental health protections — actually builds on the work of the previous administration. In 2008, President George W. Bush signed into law the bipartisan Mental Health Parity and Addictions Equity Act, which required insurers who already sold coverage for mental health and substance use disorder services to cover them just as they cover physical health; no more discrimination against our brains as opposed to the rest of our bodies. This hard won victory was actually playing catch-up to the example we set here in Colorado. We had passed parity laws in 1997 and 2007 that went even further to protect consumers by ensuring plans sold in Colorado included mental health coverage. Then in 2010, President Obama signed the Affordable Care Act, which expanded the consumer protections of the Mental Health Parity and Addictions Equity Act, and like Colorado required that starting in 2014 all new health plans must include mental health and substance use disorder services as a category of essential benefits.

The early implementation of the Affordable Care Act has been complicated and fraught with technical challenges, but in Colorado alone over 67,000 folks have signed up to purchase private coverage through our new state marketplace, the nationally praised Connect for Health Colorado. More than 100,000 newly eligible low-income adults in Colorado have enrolled in Medicaid since October of last year, allowing them to access lifesaving and life-improving health care, including mental health and substance use disorder treatment. For many of these people reform means the ability to access health care for first time in their lives. We still have a long way to go to help more people be prepared and get covered, but we are moving forward.

These two major policy changes, signed into law by Presidents Bush and Obama, are starting blocks, not the finish line. Even with expanded access to coverage that includes equality for mental health, there are still many challenges to improving the health and health care of all Coloradans. We need to end the stigmatization of mental health, fully integrate mental and physical health services, expand access in rural areas, recruit and train a new generation of health care workers. Thankfully, national health care reform has spurred more Coloradans to take personal responsibility and invest in their own health and health care, empowering them to become better caretakers of the next generation. It has also inspired Coloradans by showing them that when we the people take charge, change is possible.

Mental Health America of Colorado’s 2014 Legislative Education and Advocacy Day (LEAD) on Feb. 21 is about Coloradans taking charge of their health and health care using the tools of health care reform. Our LEAD program, featuring Colorado Commissioner of Insurance Marguerite Salazar as keynote speaker, will focus on what all of us can do build a healthier future for ourselves and generations to come. We invite our fellow Coloradans to learn more about LEAD, and to be a part of our vision for a healthy Colorado.

For information about LEAD 2014, visit www.mhacolorado.org.

Don Mares, President & CEO of Mental Health America of Colorado, is a family member of an individual with a mental health condition. Before joining MHAC Don was a lawyer, state senator, Denver City Auditor, and the director of the Colorado Department of Employment & Labor.