The new platform for our health and behavioral health coverage.

By: Michele Husted

Now that the election is over and our new president has been elected, one of the topics of worry and discussion is health care for our nation. Health care is obviously one of the primary areas our country needs to keep a priority, including mental health care.

Obamacare and Mental Health Care

Obamacare helped so much with mental health treatment — In 2013, a person with a bipolar diagnosis was unable to obtain private individual health insurance. The same was true for people with schizophrenia and other psychotic disorders and a variety of other serious mental or behavioral illnesses.

Under the Affordable Care Act or Obamacare, a law was signed in that all insurance carriers must offer mental health insurance. One in five American adults will experience a mental health issue at some point. Although, historically millions have not gotten the care they need, due to the challenges of the health insurance market.

Trump wants to either amend Obamacare or repeal and replace it. At this point no one knows what that means. Right before the election many were signing up for coverage wanting to take advantage. Currently 20 million are enrolled in Obamacare.

Right now many of you are planning and reviewing, and debating plans for yourselves for the next year. Open enrollment has started for 2017 insurance plans. Here are some of the important deadlines:

November 1, 2016: First day to enroll, re-enroll, or change a 2017 insurance plan through the Health Insurance Marketplace. Coverage can start as soon as January 1, 2017.

December 15, 2016: Last day to enroll in, or change plans for coverage to start January 1, 2017.

January 1, 2017: 2017 coverage starts for those who enroll or change plans by December 15.

Trump has gone back and forth on medicare but has a plan in place to repeal Obamacare. He is going to put in place his Trumpcare platform. The Committee for a Responsible Federal Budget thinks that this would end up costing taxpayers $550 billion dollars over 10 years. Trump does think that there should be changes to privacy laws for families of patients in order to ensure adequate care. He has not detailed any specifics but has alluded to Mental Health bills such as Helping Families in Mental Health Crisis Act.

What Trumpcare Means For Medicare and Medicaid

The majority of Republicans want to cut Medicare and Medicaid. If the Affordable Care Act is repealed and replaced, how will that affect Medicaid expansion?

Trump has proposed turning Medicaid into a program that gives states block grants rather than placing restrictions on the spending. Republicans in Congress, meanwhile, have long sought to add conditions to the program such as premiums or work requirements.

Some had hoped Medicaid would expand to be more in line with universal healthcare. While others just wanted matching funds for a time for Medicaid expansion.

Just this past week, Lamar Alexander the Chairman of the Committee on Health, Education and Labor said,

“I imagine [it] will take several years to completely make that sort of transition to make sure we do no harm, create a good healthcare system that everyone has access to and we repeal the parts of Obamacare that need to be repealed,” the Tennessee Republican told reporters on Thursday.

“Eventually, we’ll need 60 votes to complete the process of replacing Obamacare and repealing it because Obamacare was not passed by reconciliation; it was passed by 60 votes. And it was cleaned up by reconciliation because Scott Brown won his election,” he said.

Many insurers, including Anthem with Blue Cross Blue Shield plans in 14 states, and Centene who is the nation’s largest Medicaid insurer  (on the day of the election Centenes stocks plummeted), remain committed to the Obamacare marketplaces despite their dismal financial performance.

Will Trump Continue Any Obamacare Policies?

Insurance carriers are stuck by the laws that are in place. Of these coverage laws two Trump says that he will continue with coverage for a preexisting condition and that children be allowed on their parents insurance until age 26.

The sticky web with insurance carriers is that while they say those conditions are costing the insurance carriers (why UBH wanted to bow out) little is said about the donations those insurance carriers have made Aetna, Humana, UnitedHealth Group and WellPoint — which together control 28 percent of the health insurance market — gave$10,000 apiece to Cantors campaign committee. That doesn’t include additional sums that went into the congressman’s leadership PAC.

Behind Cantor, Rep. David Camp, R-Mich., ranks second in health insurance industry contributions. The chairman of the powerful House Ways and Means Committee has pulled in more than $234,000 from these PACs since 2007.

“The American people have told us they don’t want to be forced to buy health insurance that they don’t want and they can’t afford,” A year later, Camp supported to cut $11.6 billion in funding for the law.

Rep. Paul Ryan, R-Wis., is also among the top recipients of funds from health insurance companies and a leader in House’s efforts to repeal the health care law. Receiving $187,000. Ryan, influential House Budget Committee, had sponsored two major budget plans that called for the law’s repeal.

Now we wait for the answers to any changes that may arise with our new president in office. For now we know that none will take place immediately, but over time. One thing is certain, that finally mental healthcare has been made a priority and with one in five people seeking out treatment, there should be a secure future for providers who offer mental healthcare services.  There is no doubt those in this country want to have access to quality mental healthcare, there is some disagreement on who should benefit, based on their status as an American, the funding, and how to go about it. Food for thought as will continue through the inauguration process.

At Denmaar Psychiatric Billing keeping our clients informed of changes taking place at all levels is vital to ensuring that claims are reimbursed at the highest level.  Have a question? Or need billing assistance? Visit our contact page and a representative will respond to you within 24 hours!

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