Obamacare Rules: Insurers Must Offer Mental-Health Coverage

Thursday, 21 Feb 2013 12:29 PM

By Christiana Lilly

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Health-insurance companies were given a list Wednesday of “essential health benefits” to be covered next year when Obamacare goes into full effect. For some 32 million people, it’s expected to provide mental-health coverage for the first time.

According to The New York Times, the list was issued under a federal rule laying out 10 categories of coverage insurance companies must provide, ranging from mental illness, drug and alcohol addiction treatment, to prescription drugs and newborn care.

According to the White House, 20 percent of those with insurance now have no mental-health coverage and about a third have no coverage for substance-abuse treatment.

Obamacare: Massive New Rules Revealed for 2013

Health and Human Services Secretary Kathleen Sebelius said that in addition to giving 32 million people access to mental-health care for the first time, the new rule would improve mental-health coverage for 30 million people who already have it.

The rule also sets four levels for new health insurance policies, with the least expensive and least generous coverage plans requiring consumers to pay 40 percent of the costs of their benefits. The most expensive plans, known as platinum packages, would require consumers to pick up 10 percent of their benefit costs, the Times reported.

The rule, however, does not set a nationwide, uniform standard for determining what kind of coverage benefits each level should include. That decision will be left to the states, a point of concern to some healthcare-advocacy groups that argue differing plans from state to state could drive up costs.

“We are disappointed,” Carl E. Schmid, deputy executive director the AIDS Institute, told the Times.

“We thought the federal government would spell out essential health benefits in more detail. Patients respond differently to different drugs and often need multiple drugs at the same time. Under this rule, patients might have access to a total of 500 drugs in one state and more than 1,000 in another state.”




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