Total deaths from suicide, alcohol, or drugs, what some call “deaths of despair,” increased by 51 percent from 2005 to 2016 in the United States, and drug overdose deaths increased by 16 percent per year between 2014 and 2017. These statistics reflect the well-documented opioid crisis and what some experts have called a national “mental health crisis.” The Affordable Care Act (ACA) and related benefit parity requirements led to important strides in expanding behavioral health care coverage, but the law has not yet achieved its potential to advance full access to—and timely use of—behavioral health services.
The ACA was a milestone victory for behavioral health care access in two important ways. First, Medicaid expansion has been crucial to increasing access to mental health care and addiction treatment for previously uninsured, low-income adults. Approximately 29 percent of persons who have gained coverage through Medicaid expansion, or about five million people, have a mental or substance use disorder, or both. Having health insurance is a strong correlate of receiving mental health treatment: A national survey found that 75 percent of uninsured adults with mental illness and 56 percent of uninsured adults with serious mental illness did not receive treatment.Health Affairs