The push to provide mental health care access has just taken another step in the United States. The Center for Medicare & Medicaid Services (CMS) recently finalized a rule to expand the coverage for children enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).
Under this new change members will receive the same benefits and protections as private plans, according to the revised Mental Health Parity and Addiction Equity Act (MHPEA). This expansion means more access to substance abuse and mental health treatment, two areas in need of great support in the Black community.
Despite high levels of poverty in the Black community many parents aren’t taking advantage of programs like Medicaid and CHIP. In many states parents must sign their child up for these free programs, but they first must know that their child is eligible. A study conducted in Dallas, Texas revealed that 40% of Black parents didn’t know their child was eligible for these programs.
Glen Flores, a pediatrician at Medica Research Institute and the Mayo Clinic, led this study. He said that the system isn’t set up to benefit children. “It tells us that this system is not designed to keep kids on insurance.”
Under this new rule change participants can now enjoy the benefits as their counterparts who opt to go with higher priced private plans and receive the same quality of mental and substance abuse treatment.
A list of the benefit coverage is here.
Here’s a summary of the new rule change according to Bloomberg.
- The rule will benefit nearly 23 million Medicaid members and 880,000 Children’s Health Insurance Program members in 2016.
- The rule requires that each managed care enrollee in a state be provided access to a set of benefits that meets specific parity requirements, regardless of whether the mental health/substance abuse services are provided by the managed care organization or through another service delivery system, such as traditional Medicaid.
- Requires a state to disclose the reason for any denial of reimbursement or payment for services with respect to mental health and substance use disorder benefits.
Angela Kimball, National Director of Advocacy and Public Policy at the National Alliance on Mental Illness, said that these new changes will help keep all parties involved in the know about “what’s covered and what’s not.”
“The challenge has been plans, providers, and states all needed additional guidance on how it applies to coverage” for Medicaid and CHIP, Kimball said. “Medicaid serves some of the poorest residents, and not having a parity rule jeopardized their ability to get access to mental health care. [The rule] creates clarity that will help serve the lowest income Americans.”
Why This is Important to Black People
The new expansion of coverage means more things can get paid for. Breathe a sigh of relief, you no longer have to go to the doctor holding your breath saying, “Will this be covered?” The old system was extra stingy when it came to paying for certain mental health and substance issue treatments.
Under this new plan parents will receive more cost-effective treatment that’s on par with higher priced private plans. According to the Washington Post, parents of uninsured children paid an average of $593 per hospital visit and $47 per preventive visit. Three-fourths of the parents interviewed said they delayed health care for their children due to things like finances and lack of awareness of their coverage ending.
Parents looking to see if they’re qualified for Medicaid or CHIP should visit HealthCare.Org to check their eligibility.