New healthcare rule expands benefits for substance abuse, mental disorders

The Obama administration on Wednesday finalized a key Affordable Care Act rule predicted to expand substance abuse and mental disorder benefits to 62 million Americans.

The rule, to take effect next year, lays out new “essential health benefits” standards for insurers, as required by the landmark legislation. It was designed to allow consumers a simplified and consistent way to shop for, and enroll in, healthcare plans that best suit them.

“People all across the country will soon find it easier to compare and enroll in health plans with better coverage, greater quality and new benefits,” Department of Health and Human Services (HHS) Secretary Kathleen Sebelius said in a written statement.

The new regulations also close a major gap in coverage for people suffering from mental health or drug problems. Prior to the rule, almost 20 percent of people purchasing insurance did not have access to mental health services, and nearly a third had no substance abuse disorder benefits, the agency said.

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The rule issued Wednesday includes those benefits in the new standards, a move that will extend them to 62 million people, according to HHS.

The rule will cost in excess of $100 million, earning its designation as economically significant. The exact price tag is not specified, though the agency acknowledges that insurers will incur administrative costs associated with modifying their plans to incorporate the new standards.

Consumers could also pay more, as they gain and use additional coverage laid out by the new standards, according to the 149-page rule. Some of those costs may be “economically inefficient,” the rule says.

The rule is set to be published in Monday’s Federal Register. The new standards take effect next January.