What is Health Reform?
“Health reform” refers to changes or improvements in health care policies. Recent health care reforms focus on improving health care while making it less expensive for individuals, families, and businesses. Two pieces of legislation that will significantly improve health care for those with mental health challenges and substance use disorders are the Affordable Care Act and the Mental Health Parity and Addiction Equity Act.
- SAMHSA’s Role in Health Care Reform
- Health Insurance Marketplace – How to Enroll
- Health Insurance Marketplace and Educational Resources for Partner Organizations
Affordable Care Act
The Affordable Care Act of 2010 is one aspect of a broader movement toward reforming the health care system. The Affordable Care Act makes health insurance more affordable for individuals, families, and small business owners. People living with mental health challenges or substance use disorders often have problems getting private health insurance. Now there are special insurance protections to help.
Mental Health Parity and Addiction Equity Act
The Mental Health Parity and Addiction Equity Act of 2008 requires insurance groups offering coverage for mental health or substance use disorders to make these benefits comparable to general medical coverage. Deductibles, copays, out-of-pocket maximums, treatment limitations, etc., for mental health or substance use disorders must be no more restrictive than the same requirements or benefits offered for other medical care.
Learn More About Health Care Reform
SAMHSA Produced Webinars
- Medicaid Coverage and Innovative Service Models to Finance Medications to Treat Substance Use Disorders
This May 16, 2014, webinar discusses medication-assisted treatment of opioid and alcohol dependence, Medicaid coverage and cost of medications. The webinar highlights innovative approaches in three states: Vermont, Massachusetts and Maryland.
- Helping Providers Understand MCO Networks, Qualifications, and Participation
- Crisis Services for Behavioral Health Emergencies
This May 28, 2014, Webinar discusses clinical effectiveness, funding and cost effectiveness of such efforts as short-term crisis residential services, mobile crisis services, hotlines and warmlines and crisis stabilization for persons experiencing mental health emergencies. The Webinar highlighted innovative approaches in Tennessee, Washington and Wisconsin.
Essential Health Benefits
- Understanding and Evaluating Benchmark Plan Options for Your State*
- How to Apply Parity to Behavioral Health in EHB Plans
- Gaps Between Recommendations by the Coalition for Whole Health and Your State’s EHB Plans
Eligibility and Enrollment
- Training #1 Requirements and State Choices Within Medicaid and Affordable Care Act Insurance Exchange Outreach and Enrollment Assistance Regulations
- Training #2 Enrollment & Eligibility Series: Eligibility, Enrollment, and Outreach Best Practices for State Substance Use and Mental Health Leadership
- Training #3 Enrollment & Eligibility Services: Network Development, Provider Network Enrollment, and Newly Eligible Needs Assessments