A new study shows that over 2.5 million Americans who have a serious mental health condition in 34 states will become uninsured in 2016, if the Supreme Court rolls back tax credit subsidies that currently make it affordable for those individuals to purchase coverage on federally-run health insurance marketplaces under the Affordable Care Act (ACA).
The report highlights that 3.2 million citizens with serious mental health conditions in 34 states that have federally-run exchanges, are currently receiving subsidies that help offset the cost of monthly health insurance premiums. Only about a third would be able to keep some form of private health insurance.
The report, "Pulling the Rug Out from Under: Over Two Million People With Serious Mental Illnesses Would Become Uninsured if the Supreme Court Kills Health Insurance Subsidies", issued by the American Mental Health Counselors Association (AMHCA), shows that, on average, 87 percent of people buying health insurance coverage in their states through the federally-run health insurance marketplace, receive subsidies to purchase coverage. Without those subsidies, it is clear that many people with mental health disorders – and others with serious chronic conditions such as hypertension and diabetes who also have a mental health condition – would not be able to afford monthly health insurance premiums.
About 1.6 million people with major depression, schizophrenia, bipolar disorder, post-traumatic stress disorder, panic and anxiety disorders – and other related conditions – would lose their health insurance coverage in 2016, according to the new subsidy report by AMHCA, if the Supreme Court rules that only people residing in states that set up their own insurance marketplaces are eligible to receive tax credit subsidies.
Another 1.1 million Americans with serious, chronic substance abuse disorders, such as opioid or heroin use, would also lose their coverage.
Over 6 million lower- to middle-income Americans with a serious mental health condition are eligible for health insurance coverage through the ACA's federal health insurance marketplace (healthcare.gov) and the individual 14 state-run exchanges.
This latest legal challenge to the ACA, called King v. Burwell, alleges that seven words in the statute, "through an exchange established by the state," signify that only state-run health insurance marketplaces are permitted to provide federal subsidies. The dire effects of a ruling against the ACA subsidies in states with federal exchanges wouldn't be limited to the people who get tax credit subsidies.
"A significant goal of the ACA is to increase access to private insurance for people who have been uninsured with mental health conditions," said James K. Finley, Associate Executive Director and Director of Public Policy, for the American Mental Health Counselors Association and co-author of the AMHCA report. "The ACA accomplishes this goal by establishing marketplaces where people can purchase insurance, eliminating pre-existing medical condition exclusions that have all but foreclosed access to private insurance for people with serious mental health conditions," Finley noted.
"If the Supreme Court takes away subsidies for people with mental illness, they would have nowhere to go to find affordable health insurance," said Joel E. Miller, Executive Director and CEO of AMHCA. "After going uninsured for many years and then finally securing affordable coverage under the ACA thanks to subsidies, people with mental illness would have the rug pulled out from under them by the Court. They would be right back where they started – uninsured," Miller concluded.
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