States may decide to maintain gap in insurance coverage

In the New York Times article, Good New for Mental Illness in Health Law, Richard Friedman, MD, (07-10-2012) enumerated some of the ways the recently upheld Patient Protection and Affordable Care Act will improve outcomes for people with psychiatric problems: loopholes in mental health parity are closed, young people at the ages when many psychiatric conditions emerge have the right to remain on their parents’ policies until age 26, pre-existing psychiatric conditions are no longer grounds for refusal of coverage, and Medicare coverage for psychiatric medications is more consistently available. Dr. Friedman also pointed out an important gap as a result of the Supreme Court’s decision that states could opt out of Medicaid expansion:

In states that opt out of the Medicaid expansion, poor people with mental illness may find themselves in a terrible predicament: They earn too much to qualify for Medicaid, yet not enough to get the federal subsidy to pay for insurance.

While we do not expect New York to be an opt-out state, this is just the kind of gap that was TherapySafetyNet’s reason for existence. How exactly the new law will shape actual policy and practice remains partly a matter of speculation, but we fully expect there will remain some population of New Yorkers without health insurance, and TherapySafetyNet will continue to bridge the gap, even if it’s smaller than before.

Geoffrey Steinberg, Psy.D.

Executive Director, TherapySafetyNet