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Parity and Repealing the Affordable Care Act: Reinforcing the Incompatible

by Cory Valentine, Vice President Sales

I have spent my career of 20 years working in the behavioral health and addiction treatment field. I was fortunate enough to have a mentor early on that helped me uncover my true passion; leveraging proven behavioral principles and consulting data to assess a patients response to a specific treatment intervention. How we approach treatment outcomes is similar to how we should approach solving the biggest industry challenges like protecting parity, treatment availability, and agreeing on the true treatment economics so that we can bend the healthcare cost curve.

When I look at all of the changes that have occurred in behavioral health and addiction over the past many years, my experience tells me that simultaneously promoting parity and the repeal of the Affordable Care Act is a great example of improperly reinforcing incompatible principles.

Repeal of ObamacareUSA Today has an excellent article on the potential impact of repealing the Affordable Care Act on individuals struggling with mental health and addiction (HERE). Although this topic is a source of strong debate among individuals with opposing political views, this article outlines one component that treatment providers and supporters, regardless of political ideology, should be able to agree upon: How can we promote and support parity, but agree on repealing the ACA? Although the two subjects are complementary, they are incompatible.

Linda Rosenburg, CEO of the National Council on Behavioral Health and the USA Today writer summarized it perfectly: "The 2008 Parity law that required insurers to cover mental health and addiction at the same level they do other diseases is "useless" if there's no insurance coverage for low income patients that has to reach parity."

One of the most debated topics in the ACA is the expansion of Medicaid. The USA Today article states that nearly 30% of those who got coverage through Medicaid expansion have a mental health and/or addiction disorder. For comparison, that represents 20% of the overall population that struggles with similar disorders (approximately 68 million people). By itself, the expansion of Medicaid and the costs associated with supporting its expansion pose real financial consequences if not properly addressed. But when we couple the expansion of Medicaid in the ACA, along with the 2008 Parity Law, the debate becomes much more complicated and should be de-constructed and evaluated. Its just like the culmination of a multi-disciplinary care plan. We individually assess the patients clinical, medical, environmental needs and identify treatment interventions that specifically address each problem. The multi-disciplinary care plan represents an amalgamation of dozens (sometimes hundreds) of individual solutions that promote wellness in one patient. The solution for our biggest challenges will be an amalgamation of many specialized solutions.

So we end where we began, reinforcing views that, together, are incompatible. How can we promote parity for our patient population but approve the reduction/elimination of coverage for these patients? For many of us that have spent our entire careers working to give individuals and their families the tools they need to live productive and meaningful lives, this is not a political discussion but a clear framing of the problem so that we can collectively identify a solution. We can meet and overcome every challenge we face but it begins with clearly defining the problem (or behavior you wish to shape).

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