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Policy Focus: Affordable Care Act
Addressing workforce and service shortages

Passed in 2010, the Patient Protection and Affordable Care Act (commonly referred to as the ACA or Obamacare), aims to change how care is delivered, providing incentives for expanded and improved primary care, and creating team-based models of service delivery.

Mental Health Care Parity, or the ability to seek mental health care treatment as you would with physical health care, is mandatory under the ACA. A mental health diagnosis or a mental health episode cannot be used as a reason to reject insurance coverage applications. This will enable previously uninsured individuals to seek immediate treatment and care. Mental health remains a major public health issue and the need to provide access to quality care is imperative to limit the negative consequences faced by those who do not seek treatment, including homelessness, incarceration, suicide, crime, substance abuse, and violence. The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation. Since 2014 under the law, all new small group and individual market plans are required to cover ten Essential Health Benefit categories, including mental health and substance use disorder services, and are required to cover them at parity with medical and surgical benefits. The Affordable Care Act builds on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA, or the Federal Parity Law), which requires group health plans and insurers that offer mental health and substance use disorder benefits to provide coverage that is comparable to coverage for general medical and surgical care.

Some initial research indicates implementation of the ACA will place higher skill demands on all members of the health care workforce as health care systems try to improve quality while limiting costs. Along with the mental health parity provisions, the Affordable Care Act will provide the largest behavioral health coverage expansion for our generation. One of the major barriers to access has been basic geographic limitations. For example, in Lassen County there is only one hospital, one clinic, and a total of five health care workers for an area that covers 4,720 square miles of mountainous and isolated terrain. In stark contrast is Los Angeles County that covers more than 779,000 eligible individuals over 4,752 square miles.

In an effort to address this concern, the ACA dramatically increased funding for the operation, expansion, and construction of health centers nationwide. Today, 1,200 health centers operate nearly 9,000 service delivery sites that provide primary care to more than 21 million patients each year. Health centers across the country have also received more than $200 million to help uninsured Americans gain access to affordable health insurance coverage through the Marketplace. Emerging delivery models and expanded use of health information technology and tele-health may offer opportunities to mitigate workforce challenges. However, they are in the early stages of adoption and have not yet yielded significant breakthroughs in how to most effectively and efficiently utilize and train future health professionals.

One of the major barriers to access has been basic geographic limitations. For example, in Lassen County there is only one hospital, one clinic, and a total of 5 health care for an area that covers 4,720 square miles of mountainous and isolated terrain.  In stark contrast is Los Angeles County that covers more than  779,000 eligible individuals and covering 4,752 square miles.

In an effort to address this concern, the Affordable Care Act dramatically increased funding for the operation, expansion and construction of health centers nationwide. Today, 1,200 health centers operate nearly 9,000 service delivery sites that provide primary care to more than 21 million patients annually.  Health centers across the country have also received more than $200 million to help uninsured Americans gain access to affordable health insurance coverage through the Marketplace. Emerging delivery models and expanded use of health information technology and tele-health may offer opportunities to mitigate workforce challenges. However, they are in the early stages of adoption and have not yet yielded significant breakthroughs in how to most effectively and efficiently utilize and train future health professionals.

Providers can only mitigate problems like the coverage gaps in hidden populations, while researchers and policymakers pursue long-term solutions. Insufficient knowledge of the ACA – and an inability to capitalize on that knowledge – is the single largest barrier for providers and clients alike.

Through targeted education, training, outreach, and strategic planning, UACF is closely monitoring developments as California works to improve ACA/Covered California. We also will continue to track efforts to strengthen mental health parity in California. We remain dedicated to informing and educating parents and families on matters that will impact their children’s mental health needs.

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The transition of AB 3632 to AB114

AB 3632 is now AB 144. What does this mean for your child’s IEP? 

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Need Immediate Help?

If you or a loved one is in immediate crisis, please call 911 or visit the nearest emergency room.

The UACF Hope Line is a message system for parents and caregivers that provides resources and connections to individuals in your community that may be able to assist you in finding appropriate support services for your child’s mental health needs. Feel free to leave a message on the UACF Hope Line and your call will be returned as promptly as possible.

Hope Line: 1-877-ASK-UACF (275-8223)