While the Mental Health Parity and Addiction Equity Act of 2008 created parity in coverage for treatment of mental health and addiction, the Affordable Care Act (ACA) affects the financing and delivery of mental health and addiction care, according to the article “Moving Beyond Parity — Mental Health and Addiction Care under the ACA” published in the New England Journal of Medicine by Colleen Barry and Haiden Huskamp.

The article cites expansions of Medicaid, the employer insurance mandate, health insurance exchanges with subsidies for low-income families and other reforms as likely to result in coverage for at least 3.7 million people with severe mental illnesses who are not currently insured. Many more people with mild mental illnesses are also likely to obtain coverage for the first time under ACA. State-based insurance exchanges will require participating plans to cover behavioral health services.

The authors also expect that ipatient-centered medical homes and accountable care organizations will improve integration and quality of care for those with mental illness. The current lack of integration between providers of various medical services has meant that people with mental illnesses tend to die earlier than the general population from treateable diseases and mental disorders are often untreated by primary care physicians. ACA will require integrated care and sharing of medical records, which will mean sharing information about the mental and physical health of those with behavioral disorders.

ACA will also improve Medicaid options for those with mental illnesses. More services will be covered under Medicaid and grants will be offered to help adults with medical illnesses and medical conditions integrate their treatments and medical services.