My friend, Sarah, is currently navigating the tough landscape of mental health care. Despite having insurance, she finds herself teetering on the edge of postpartum depression and regular depression—if one can even classify depression as “regular.” Living in a rural area, her search for a doctor who accepts her insurance has turned into a daunting task. The nearest available options are at least a 40-minute drive away, and many psychiatrists in her region either don’t take insurance or aren’t accepting new patients. I truly hope she finds the help she needs soon.
I consider myself fortunate. I pay a significant amount out of pocket for my mental health care since my doctor also doesn’t accept insurance. While my medications are covered by my pharmacy, the total cost exceeds a hundred dollars each month. I can’t help but wonder how different things would be if the Affordable Care Act (ACA) hadn’t been implemented when we switched insurance plans. My multiple mental health diagnoses would make it financially impossible to afford my medications without the ACA’s protections. Sadly, my state opted out of Medicaid expansion, despite President Obama’s advocacy for it.
Now, as discussions about repealing the ACA heat up, the future of mental health care in the U.S. looks grim. According to Mental Health America, approximately one in five Americans grapples with a mental health condition—over 40 million individuals, which is more than the combined populations of New York and Florida. The ACA played a crucial role in increasing access to mental health care; as more people gained insurance, the availability of mental health services improved.
However, states that did not accept Medicaid expansion still have 19% of their populations uninsured, compared to only 13% in those that did. The Congressional Budget Office (CBO) forecasts that if Medicaid expansions are eliminated following the ACA repeal, the number of uninsured individuals with mental health conditions will soar. Currently, 56% of individuals with mental health issues lack access to necessary care. This situation is only expected to worsen with the repeal—an estimated 20 million people gained insurance through the ACA, many of whom benefited from mandated mental health parity that ensured coverage for therapy, medications, and preventative measures like depression screenings.
Without the ACA, premiums are projected to rise by 20-25% in 2018, making mental health care less accessible, even for those with insurance. The CBO has warned that by 2018, 18 million people could lose their coverage, and that figure could reach 32 million by 2026. If one in five of those individuals has a mental health condition, that translates to 6.4 million people who would be left without access to care.
Furthermore, the CBO indicates that coverage would be less comprehensive, and those with preexisting conditions—like myself, dealing with anxiety and depression—might struggle to find coverage. This could lead to skyrocketing out-of-pocket costs for essential medications, making it untenable for many.
The ACA not only facilitated access to necessary insurance but also drastically reduced premiums for many, allowing a greater number of individuals to seek quality mental health care. Tragically, without it, more people will be left without support. The CDC reported that in early 2015, a significant percentage of adults with serious mental illness did not seek care due to cost. This statistic has improved since the ACA was introduced, but without it, we could see a dramatic increase in those unable to access the support they need.
The repeal of the ACA threatens to dismantle the progress made in mental health care access, leaving countless individuals vulnerable. If you’re curious about the implications of these changes or seeking information on home insemination, check out this excellent resource on treating infertility.
In summary, the repeal of the ACA poses a significant threat to mental health care access, risking the well-being of millions of Americans. With rising premiums and reduced coverage, many individuals could find themselves without the essential care they need.