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Health Reform

Using the Provisions of the Affordable Care Act to Improve Children’s Behavioral Health Services

America is in a new era of health care reform. The March 21, 2010 signing of the Patient Protection and Affordable Care Act (ACA) into law has opened many possibilities for states to improve services and supports for millions of children in America who have, or are at risk of, mental health or substance use disorders. Expansions in the Child Health Insurance Program (CHIP) and Medicaid, new Medicaid options for delivering behavioral health services, and the establishment of state Health Insurance Exchanges offer states new tools for expanding system of care approaches to service delivery to a wider population.

Many Provisions of the ACA Are Already Benefiting American Families

  • Coverage of young adults to age 26 on their parents’ health insurance plans is reaching over 3.6 million young adults.
  • No more denials of insurance for children and adults with pre-existing conditions is helping millions of American families who previously were denied coverage.
  • Elimination of annual and lifetime limits on insurance benefits and parity regulations are widening access to treatment for children with behavioral health disorders and their families.
  • Medicaid coverage of young adults to age 26 who are exiting foster care means that tens of thousands of youth and young adults can continue to access behavioral health services often delivered through systems of care approaches.
  • Maternal, Infant, and Early Childhood Home Visitation Programs in 49 states, DC, territories and Tribes offer children’s mental health administrators new early identification and intervention tools with vulnerable families.

Medicaid & SCHIP

For children and youth with mental health and substance use disorders who are eligible for Medicaid, the ACA gives states new options for expanding systems of care approaches to service delivery, including:

  • Expansion of Medicaid to 138% of poverty
  • Increased CHIP enrollment
  • Medicaid 1915(i) State Plan Amendment
  • Health Homes
  • Accountable Care Organizations
  • Money Follows the Person

These options can be adopted and tailored by states to innovate in service delivery, support comprehensive and culturally specific service delivery approaches, and to support their system of care expansion goals.

How the Georgetown University National Technical Assistance Center for Children’s Mental Health (TA Center) Helps States, Tribes, and Territories Implement Health Reform

The TA Center helps states, tribes, and territories understand the provisions of the Affordable Care Act, what the opportunities are for using ACA provisions to enhance children’s behavioral health, and what is required to adopt and innovate with the provisions. The TA Center provides states, tribes, and territories with the latest information about Health Reform and connections with other states that are implementing ACA.

Medicaid options to reach similar system of care expansion goals:

  • The TA Center Issue Brief titled,The Intersect of Health Reform and Systems of Care for Children and Youth with Mental Health and Substance Use Disorders and Their Families,” outlines key provisions in the ACA with the greatest potential to positively impact children and their families
  • The TA Center website is tracking state health reform initiatives with “how to” information to assist other states considering similar reforms
  • Faculty host webinars on Health Reform and make numerous conference presentations to highlight how the ACA can impact children’s mental health services
  • Faculty consult with individual states, tribes, and territories to help them understand the ACA and to identify specific sections of the Act that fit with their goals for improving services

Contact Information

For further information or additional questions, please contact:
James Wotring, M.S.W.
National Technical Assistance Center for Children’s Mental Health
Center for Child and Human Development, Georgetown University