Study Shows Benefits Of Affordable Care Act In Access to Mental Health Care

A recent study in the AMA’s Psychiatry journal found that because of the Affordable Care Act, access to care in the United States has improved for adults with moderate and severe mental illness.  The Vanderbilt study looked at access to mental health care for adults in 2012-2013, prior to ACA benefits being implemented, and in 2015.  The sample included 77,095 adults aged 18 to 64 years.  Using the Kessler 6 (K6) scale, the scores of which range from 0 to 24, with higher scores indicating more severe psychological distress, the study team classified adults as having moderate mental illness (scores from 5 to 12 points), severe mental illness (scores of 13 points or higher) or no mental illness (scores from 0 to 4 points).

In both periods, adults with severe mental illness were more likely to be unemployed, have low income, and have poor or fair health, they report. After passage of the ACA, and after controlling for sociodemographic factors, there was a decrease in uninsured adults with no mental illness (-6.2 percentage points) and moderate (-8.5 percentage points) and severe mental illness (-9.3 percentage points).

In addition, in 2015 there was a significant drop in the percentage of adults with moderate mental illness with no usual source of care (-3.5 percentage points), delayed medical care (-4.5 percentage points), forgone medical care (-3.3 percentage points), and forgone prescription medications (-3.6 percentage points).

Passage of the Affordable Care Act expanded health insurance to roughly 21 million Americans through insurance reforms, Medicaid expansions, and subsidies for coverage in the marketplace. The law is still on the books but subsidies to insurers that make it worth their while to participate are no longer certain, the Department of Health and Human Services is doing significantly less to promote enrollment, and the tax bill moving through Congress may no longer penalize people for not having health insurance.  Premiums are rising in many jurisdictions, to some extent simply because of the uncertainty insurers face about the future of the program.  Insurers don’t like uncertainty. 

You can find the study here