Good News for Mental Health – Supreme Court Decision Offers More Benefits for Treatment of Mental Illness

In a 5 to 4 decision, on June 28, 2012, the Supreme Court upheld the constitutionality of the cornerstone provision of President Obama’s Affordable Care Act, the individual mandate. In the Court’s majority decision, which was written by Chief Justice Roberts and concurred in by Justices Breyer, Ginsburg, Sotomayor and Kagan, the law’s individual mandate was ruled a valid exercise by Congress of its taxing power. Justice Kennedy, who was widely viewed as the likely swing vote, joined with Justices Scalia, Alito and Thomas in a dissenting opinion. A surprise to most was that the controlling swing vote in favor of upholding the law proved to be that of the Chief Justice. 

Americans suffering from mental illness, as well as their providers, now have reason to celebrate, as the Affordable Care Act  promises to give them something they never had before, namely health insurance not just for medical conditions, but also for psychiatric disorders as well.  Previously, individuals suffering from mental illness faced higher deductibles, annual and/or lifetime caps on coverage or no coverage at all.  Under the Affordable Care Act, psychiatric illness is treated like any other illness, thus removing obstacles to fair and reasonable treatment.  Exclusion of individuals based on pre-existing conditions is forbidden, which is significant in the mental health field, as half of all serious psychiatric conditions are present by the age of 25.  Older Americans benefit as well, because the law will eventually fill in the Medicare drug coverage gap.

Employers must plan now for the full impact of this law.  Given the uncertainty about the constitutionality of the law prior to the Court’s decision, many employers with health care plans delayed focusing attention or resources on compliance with the new law by the 2014 full implementation date. The Supreme Court’s recent decision upholding the law, however, means that a “wait and see” approach is difficult to justify.  The 18 months remaining between now and January 1, 2014, is a relatively time in which to implement full compliance with the notice, administration and benefit changes health plan sponsors will have to implement.

We represent clients throughout eastern Pennsylvania, including the Philadelphia Main Line (Merion, Narberth, Gladwyne, Wynnewood, Ardmore, Haverford, Bryn Mawr, Rosemont, Villanova, St. David's, Radnor, Wayne, Strafford, Devon, Berwyn, and Paoli) and the communities of Newtown Square, Malvern, Valley Forge, Philadelphia, Phoenixville, Reading, Doylestown, West Chester, Media, Lancaster, Allentown, Stroudsburg, Norristown, and Easton.

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