Health Reform

In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (together referred to as the Affordable Care Act) that make health insurance coverage more affordable for individuals, families, and the owners of small businesses. The Affordable Care Act is one aspect of a broader movement toward a reformed behavioral health system. For the behavioral health field, "health reform" includes MHPAEA, Olmstead1 and early periodic screening, diagnosis, and treatment (EPSDT)2 issues, integration with the broader health system, and increased use of health information technology (HIT). More specific efforts are also important to the reform of the behavioral health system, such as the National HIV/AIDS Strategy, the Tribal Law and Order Act, and the National Action Alliance for Suicide Prevention.

These developments present SAMHSA with the challenge of managing and responding in an environment of rapid, dramatic change. Health reform also presents opportunities to make a positive impact on health and behavioral health systems, services, and payer sources. Through this Strategic Initiative, SAMHSA will work to include persons in need of services for mental and substance use disorders; their family members; and the practitioners and providers who serve them in all aspects of health reform.

The Affordable Care Act reforms insurance markets to make them more competitive. It protects consumers' rights by prohibiting such practices as excluding people from coverage due to preexisting conditions, placing annual or lifetime caps on coverage, banning rescission of coverage, and establishing basic minimum benefit packages. The Affordable Care Act addresses the reality that racial and ethnic minority populations are disproportionately uninsured, face systemic barriers to health care services, and experience worse health outcomes. The Affordable Care Act also includes prevention, early intervention, and treatment of mental and substance use disorders as an integral part of improving and maintaining overall health. When fully implemented, the Affordable Care Act will provide access to coverage for an estimated 32 million Americans who are now uninsured. It will ensure that mental health and substance use services for newly covered individuals are provided at parity, consistent with the MHPAEA passed in 2008. For more information on SAMHSA's role in health reform see SAMHSA's Leading Change: A Plan for SAMHSA's Roles and Actions 2011 – 2014.

Last updated: 03/30/2011

  1. In 1999, the U.S. Supreme Court issued the landmark Olmstead decision applying the Americans with Disabilities Act to the right of individuals with disabilities to receive health care in a community-based setting.
  2. This child health component of Medicaid is required in every State.
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Did You Know?

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Research on California showed that treated patients reduce medical costs by 26%, and reduce ER visits by 36% when compared to a control group.

Source: Cost Offset of Treatment Services