In his recent State of the Union Address, Biden revealed his plan to improve mental health care and drug treatment in the United States. The President said he is seeking to close the gap in coverage for the millions of Americans struggling to get the care they need, and his plan would call upon insurers to include more coverage and doctors visits for no additional cost to patients. His plan will additionally seek to remove discrimination and increase affordable healthcare networks for the general public. If Biden’s plan is successful, health insurance will have new regulations and guidelines.
The Current State of Mental Healthcare
As of 2014, most individual and small group health insurance plans are required to provide coverage for mental health treatment and services related to substance abuse disorders. All state Medicaid programs and children's health coverage plans also include some coverage for mental wellness. Typically, these coverages include visits such as a psychiatrist, phycologist, in-patient treatment programs, and outpatient programs. Most plans also offer coverage for medication related to mental health treatment. These services are subject to any existing deductibles or co-pays and vary per individual plan.
But regardless of plans having some inclusivity of mental health coverages, most Americans report that they are too expensive and inaccessible to be of any real benefit. Spending on mental health treatment and services reached $225 billion in 2019, according to an Open Minds Market Intelligence Report. In 2021, more than half of adults struggling with a mental health condition did not receive any treatment. This is over 27 million adults in the U.S. who are going untreated due to financial reasons, and lack of access.
A recent study on the root of poor mental healthcare found that one in five Americans have had to choose between treatment for a physical health condition and a mental health condition due to their insurance policy, even when they were in need of both. More than half of Americans who have needed treatment believe that it is the responsibility of the government needs to standardize and improve the coverages offered through insurance.
Biden’s New Plans With Set Minimum Coverages For Americans
Under Biden’s proposed mental health plan, current health insurance policies will be under deep scrutiny and reformation. A major detail of the plan disclosed in his state of the union speech is that insurers will need to provide a minimum of 3 annual mental health visits, free of charge to Americans. If the plan is successful, this would dramatically improve access to both annual physicals and annual mental health visits.
His plan also includes a multi-billion dollar plan to boost resources and education around mental wellness. Biden called for an increased focus on behavioral health services for kids and young adults. Proposed changes would have insurers cover behavioral health services and increase access to adequate providers. These initiatives aim to simultaneously improve insurance plans and education around healthcare, to close both coverage and access gaps. The structure of coverage now is highly based on the cost of the plan, as well as the specific provider. So, higher-cost plans tend to offer more visits. This new proposal will mandate all insurance plans, regardless of cost, to give access to essential appointments and healthcare. For many Americans, this would be life-changing.
A Virtual Future for Healthcare
Another focus for the Biden-Harris administration is the expansion of telehealth and virtual doctors. The frequency of telehealth visits increased dramatically over the course of Covid-19 but is not expected to be a standard option of healthcare. Virtual visits are shown to not only be effective but to reduce barriers for groups in healthcare shortage locations. While right now many telehealth visits are through specific applications or dependent on the individual medical practice, the plan is to expand this style of treatment to be included in major healthcare plans and covered by insurance. While details around telehealth coverage are still in the works for some providers, certain legislations have been passed that will expand telehealth for Medicaid, Medicare, and children's health.
It was clear in Biden’s State of the Union address that there will be increased pressure on insurance companies and legislatures to improve access to mental healthcare. Right now in the United States, 1 in 5 suffers from a mental health condition. Unfortunately, most of those cases go untreated due to lack of access, stigma, or financial reasons. Though the specifics of Biden’s plan will only be confirmed with time, one thing is for sure it is the responsibility of healthcare companies to give fair and equal mental healthcare to all Americans.
Insurance Coverage with ECBM
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