NAMI - The National Alliance on Mental Illness

What is the new health care law?

The Patient Protection and Affordable Care Act (ACA) commonly called the new health law or the Affordable Care Act, was signed into U.S. law on March 23, 2010. Together with the Health Care and Education Reconciliation Act, the law is intended to increase access to health insurance coverage for Americans and is aimed at reducing the costs of health care.

For people living with mental illness, the law will result in health insurance coverage for some services and treatments that have traditionally been denied or were not included in health insurance coverage in the past. The law has a significant impact on all health insurance plans, including public sector (Medicaid, Medicare, CHIP, VA and other health care) as well as private sector health insurance plans.

The ACA will result in many changes that will take place over time. Some of these changes began in 2010 and others will take place through 2014. This information has been created to help individuals and families affected by mental illness to better understand these changes and to prepare for those that will be coming.

• Download the Health Coverage Fact Sheets
• Download the Mental Health Parity Toolkit
• Download the Policy Maker's Toolkit
• Download the Medicaid Report: Medicaid Expansion and Mental Health Care

FAQ: (Click the question to expand)

• How is mental health care insurance provided to those in need?

  • The American health care system is a combination of public and private programs and financing mechanisms. Most Americans get private health insurance through their job while a number of federal, state and local strategies are used to cover health costs for Americans who do not get individual or employer sponsored private health coverage.

    Learn more about how health and mental health care is covered today.

    Fact Sheet: Coverage for Care

• With implementation of the health reform law, what options will be available to me for new, additional or expanded mental health care insurance?

  • The health reform law, the Patient Protection and Affordable Care Act (ACA), offers new choices for quality, reliable, low cost private health insurance and opens Medicaid to more people living with mental illness. The health reform law requires most Americans to have health insurance, but also makes it easier to get and more affordable. In 2014 uninsured Americans will be able to buy a private insurance plan that meets their health care and financial needs through online state health insurance marketplaces. In addition, Medicaid will be expanded to ensure coverage for Americans with lower incomes.

    Learn more about new coverage for Medicaid and private insurance.

    ACA Fact Sheet #1 Overview: Health Reform and Mental Health
    ACA Fact Sheet #3 Medicaid Expansion and Mental Health
    ACA Fact Sheet #4 Private Health Insurance: New Mental Health Options

• I am a Veteran. What do I need to know about insurance for mental health care that will help me and my family?

  • Help is on the way for millions of uninsured veterans and their families. The Veterans Health Administration (VHA) has seen a dramatic increase in demand for mental health care yet veteran status, service related disability, income level and distance from VHA facilities leave many without access to care. Veterans who are uninsured or underinsured will see more choices for expanded mental health care.

    Learn more about new health coverage for veterans and their families through private insurance or Medicaid.

    ACA Fact Sheet #7 New Mental Health Coverage for Veterans

• I am a Hispanic American. What do I need to know about insurance for mental health care under the health reform law? Who will have access to insurance and who will not?

  • Nearly one in three Latinos in the U.S. are uninsured. Some people will have access to health insurance and others will not, however. Most immigrants will qualify for health insurance and the same choices available to other citizens. Undocumented immigrants will not qualify for insurance.

    Learn more about new health coverage for Latino families.

    ACA Fact Sheet #8 New Mental Health Coverage for Latino Families Part
    ACA Fact Sheet #8 Nuevas Opciones del Seguro de Salud

• Does everyone need to have health insurance under the health reform law?

  • The health reform law requires most Americans to have health coverage beginning in 2014. If you like the coverage you have now, you can keep it. If you and your family are covered through an employer or individual health plan, Medicaid, Medicare, CHIP, TRICARE or the VA, you will meet the requirement as having insurance. If you do not have coverage, you will need to get insurance or pay a tax penalty unless your income is too low to qualify for help to buy insurance and you do not qualify for Medicaid.

• What is available now through the health reform law what do I need to know before 2014?

  • Currently, private health insurance is often costly, hard to get and may not cover needed care. The health reform law requires health insurance companies to follow new rules to deliver fair and dependable coverage. There are many protections in place to ensure that individuals and families are cared for in their health insurance policies. Each state is developing their response to the law through a variety of strategies, including the development of state health insurance marketplaces, and in some cases, the expansion of Medicaid. Individuals should begin to learn what protections are in place and what to expect now and in the future as the law is implemented fully.

    Learn more about how the health reform law protects you.

    ACA Fact Sheet #5 Customer Protections in Health Reform

• What health insurance benefits will be mandatory as part of the health reform law?

  • The health reform law lays out rules for insurance plans that are intended to help you access the care you need. These are called essential benefits and there are mental health benefits that must be offered in all health insurance plans. There are 10 Essential Health Benefits that are important to understanding what will be mandatory in new insurance plans that begin in 2014.

    ACA Fact Sheet #6 Essential Health Benefits

• I have heard a lot about the issue of Medicaid expansion. What does this mean to me in my state?

  • Medicaid is a federal/state health financing program that pays for nearly half of all public mental health care. At first, the health reform law required all states to expand Medicaid based on income, but a 2012 Supreme Court decision made Medicaid expansion optional for states. The discussions and decisions about whether to expand and what that looks like is being determined by each state, through the state Governor's office and the state Legislature.

    The outcome of this decision will have a significant impact on not only the individual citizens of each state but to the health care system overall. As of May 2013, these discussions and decisions have been resolved in some states but the debate and outcomes remain in-flux in other states.

    Learn where your state stands on Medicaid expansion.

    Learn more about the Supreme Court decision and mental health ACA Fact Sheet #2: The Supreme Court Health Reform Decision and Mental Health

    Learn more about Medicaid and Mental Health Care ACA Fact Sheet #11: Medicaid and Mental Health

Need Health Insurance?

Enrollment starts October 1, 2013; new coverage will start January 1, 2014.

Learn more about how to explore your options and apply at Healthcare.gov