Affordable Care Act/ACA Fails Seriously Mentally Ill

Many 'mental health' advocates claim that the Affordable Care Act (ACA, a/k/a "Obamacare") combined with "mental health parity" will ensure people with mental health issues get care. The ability to keep a child on your insurance until age 26 will likely help many, since serious mental illness affects people in their late teens, early twenties. Maybe other provisions will help the higher functioning. But as the analysis below shows, overall, it makes things worse for the most seriously ill: those who need long term hospitalization.  Unfortunately, the impact of ACA on the most seriously mentally ill has been largely ignored by 'mental health' advocates.

Obamacare & Supreme Court leave mentally ill uninsured

While some are condemning and others applauding the Supreme Court decision on health care reform, the decision leaves in place federally mandated discrimination against people with mental illness. As I pointed out with Mary Zdanowicz in this Washington Post op-ed

For the most severely mentally ill, private insurance is essentially meaningless. Because of their illnesses, most are indigent, and private insurance is a luxury they cannot afford....Medicaid...covers their care, except for a single exception--inpatient care in psychiatric hospitals. The federal government's Institution for Mental Diseases (IMD) exclusion prohibits Medicaid from reimbursing for most individuals who need care in a psychiatric hospital. If you have a disease in your heart, liver or any other organ and need treatment in a hospital, Medicaid contributes. But if you have a disease in your brain and need care in a psychiatric hospital, Medicaid does not.

The ruling by the Supreme Court does not change this. States will continue to declare mentally ill who are hospitalized 'well', and discharge them sicker and quicker into the community while pretending that is humane care. As a result of this, many people with serious mental illness will go shelters, others to jails and prisons, and too many to morgues.

Health Care reform that leaves out the most seriously mentally ill is a national shame.