Bob GebbiaChief Executive Officer

American Foundation for Suicide Prevention

Why Mental Health Care is Important to Suicide Prevention

What About Mental Health Parity Under

the ACA

How AFSP is Helping Consumers in the

Marketplace

Why Mental Health Care is Important to Suicide Prevention

90% of those that die by suicide have a diagnosable and treatable mental health disorder

As many as two thirds of people with depression do not seek treatment

Only 50% of persons diagnosed with major depression receive any kind of treatment

Mental Health Parity

AFSP advocated for MH Parity, passed in October 2008

Seeks to eliminate discriminatory access to mental health (MH) and substance use disorder (SUD) benefits

Incorporated into ACA, final rules issued November 2013

Plans subject to federal parity law precluded from offering MH and SUD benefits in a more restrictive way than other covered

medical and surgical benefits

ACA builds on the Mental

Health Parity and Addiction Equity Act of

2008 by including mental

health, substance use

disorder benefits in the

Essential Health Benefits

By applying federal parity protections to mental health and substance

use disorder benefits in

the individual and small

group markets

By expanding parity

requirements to millions of

Americans whose

coverage did not

previously comply with

these requirements

Copays, coinsurance, and out-of-pocket maximums

Limits on services utilization, such as number of inpatient days or outpatient visits that are covered

Coverage for out-of-network providers

Mental Health Parity Applies to:

Employer-funded plans with more than 50 insured employees

Non-grandfathered employer-funded plans with 50 or fewer employees

Individual market plans

Medicaid managed-care programs

Who Must Provide Equal Coverage?

Small employer plans created before March 2010 (these are grandfathered and exempt from the requirements)

Church-sponsored plans and self-insured plans sponsored by state and local governments

Retiree-only plans

TriCare

Medicare

Traditional Medicaid (fee-for-service, non-managed care)

Parity does not apply to:

Who is responsible for implementation?

• States have primary authority for implementation

• Center for Medicare / Medicaid has authority over compliance

The Affordable Care Act will extend federal parity

protections to 62 million Americans

Individuals who will gain mental health, substance

use disorder, benefits under the

ACA

Individuals with existing mental

health and substance use

disorder benefits who will benefit

from federal parity protections

Total individuals who will benefit

from federal parity protections

Individuals currently in individual plans

3.9 million 7.1 million 11 million

Individuals currently in small group plans

1.2 million 23.3 million 24.5 million

Individuals currently uninsured

27 million n/a 27 million

Total 32.1 million 30.4 million 62.5 million

FOR MORE INFORMATION ON MENTAL HEALTH PARITY?

www.cms.gov www.dol.gov www.samhsa.gov

Visit www.commonwealthfund.org to view an interactive map to review the status of state action on state health insurance marketplaces, also called exchanges, and view

key aspects of state-run marketplaces

AFSP PARTNERED WITH THE NATIONAL COUNCIL TO CREATE A TOOL FOR CONSUMERS LOOKING

FOR OF MENTAL HEALTH CARE

AFSP is Collaborating with the National Council for Behavioral Health

Mental Health Consumer Tools

Mental Health Parity and the ACA: Mental Health Services in the New Insurance

Marketplace

This tool:

Provides consumers with information about mental health parity and key things to consider when selecting a plan

Your Mental Health Needs and the New Insurance Marketplace!

This tool:

Provides consumers with information about how insurance plans work, basic components, coverage levels available to them, and how to select a plan that meets their mental health needs

Appeals and Exceptions: How to Access Mental Health Services in Qualified

Plans

This tool:

Provides consumers with information about how to request services or meds not covered by using: Prior Authorization Requests Exceptions Appeals

What’s Next?By early March:

• Final design will completed

• The new consumer tools will be on the AFSP and NCBH websites, and linked to other sites