The organizations represent consumers, advocates and providers of mental health services and express concern that the regulation defining Essential Health Benefits must ensure access to essential mental health services for those with mild, moderate and severe disorders.
a skeleton basic benefit,
that plans be given additional guidance on evidence-based services that can offset unnecessary institutionalization or future treatment costs, and
that standards for access and coverage of the benefits are also provided.
As background, we know that individuals with mental illnesses and substance use disorders tend to have high health care costs due to the significant level of co-occurring disorders such as hypertension, heart disease, and diabetes. We also know that one way to reduce health care costs overall is to encourage insurers to provide effective and targeted services for this population.
The Affordable Care Act requires that the Essential Benefit package include mental health and substance abuse services at parity with other medical/surgical care, prevention services and rehabilitative services.