A New Mental Health Act

Paul Ballas Health Guide
  • The treatments for schizophrenia have improved significantly over the past few decades, but many patients and their families are frustrated by having to pay a higher copay for seeing a psychiatrist than for seeing any other specialist. This is in part due to a long history of distinction between mental and physical health in many insurance plans. A new act was signed into law October 3 that will hopefully improve the situation starting in 2010. The Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act was signed by President Bush and may help the 113 million Americans who do not have equal coverage between mental and medical health care services. 

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    This will not affect people who have insurance that doesn't cover psychiatric illness, nor the millions of uninsured in the country, but for the people who have insurance plans that cover mental health, there will be several benefits. First, copays for psychiatric visits, psychologist visits, and other mental health outpatient services will now be equal to that of the typically less expensive medical copays. Insurance plans often have caps on the number of days a person would be in the hospital and how many psychiatric visits a person can have annually. This can be very frustrating to families, particularly because so many patients get better with therapy. This new law will get rid of these caps, so it will be between the doctor and the patient who determine how much therapy the patient has.  Lastly, this new law will permit out-of-network psychiatrists if the insurance plan covers mental health and allows out-of-network physicians to provide medical care. 

     

    As I mentioned above, this law only affects insurance plans that cover mental health.  Companies that have less than 50 employees are also exempt from these new adjustments. Also, the law allows the insurance plan to pick and choose which disorders are covered. 

     

    Overall the law should provide more coverage for many Americans. If you and your family are not affected by this law, I wouldn't expect any changes any time soon. The Mental Health and Addiction Equity Act of 2008 builds on several other laws aimed at expanding mental health coverage, the last law of its kind was the Mental Health Parity of 1996. So if this law doesn't affect your current situation, despite what the politicians have been saying about health care reform, it took 12 years to get this much progress, so don't hold your breath for more change coming any time soon. 

Published On: October 27, 2008