Affordable Care Act to Increase Access to Mental Health Benefits

Rep. Ben Ray Luján

WASHINGTON D.C. – Rep. Ben Ray Luján of New Mexico’s Third District highlighted recent data that shows the Affordable Care Act (ACA) is expanding mental health and substance use disorder benefits for approximately 60 million Americans – including approximately 403,000 New Mexicans. This expansion of coverage for mental health and substance use disorders is one of the largest in a generation.

Thanks to the Affordable Care Act, insurance companies in the individual and small group market are required for the first time to cover mental health and substance use disorder services as one of ten categories of essential health benefits.

In addition, insurance companies must cover these services at parity with medical and surgical benefits, meaning things like out-of-pocket costs for behavioral health services must generally be comparable to coverage for medical and surgical care.

“Sadly in New Mexico we are too familiar with the impact that substance abuse has on our families and our communities. Combating substance abuse requires a comprehensive strategy, and ensuring that people have access to health care that provides quality services that help address substance abuse disorder is an important step to building safer and stronger communities,” Luján said.

The Affordable Care Act requires most health plans to cover recommended preventive services like depression screenings for adults and behavioral assessments for children at no cost to consumers. With an estimated one in five adults experiencing mental illness in any given year, the ACA will help reduce the number of individuals who go untreated due to a lack of health insurance that covers mental health and substance use disorder services.

In addition, because of the law, starting in 2014 insurers will not be able to deny coverage or charge individuals more due to pre-existing conditions, including mental illness and substance use disorders.