The Coalition for Whole Health, a national coalition of addictions and mental health organizations of which the National Council is a member, has submitted recommendations to the Department of Health and Human Services (HHS) outlining the comprehensive substance use and mental health benefits that should be included in the essential benefits package under the Affordable Care Act (ACA).
The essential benefits package is a minimum standard set of covered benefits that insurance plans must offer as a condition of participating in the state-based Health Insurance Exchanges. Medicaid expansion plans must also provide at least the essential benefits. Under the ACA, essential benefits must include substance use and mental health benefits – but the law did not specify exact services to be covered.
The Coalition for Whole Health’s recommendations outline the minimum benefits that should be included in the essential benefits package, both under the specific category of Mental Health and Substance Use Disorder Services and incorporated as appropriate under the other nine general categories of benefits. The Coalition’s recommendations include:
- Ongoing mental health and substance use disorder screening and assessments using evidence-based assessment tools;
- Substance use disorder residential treatment and intensive outpatient treatment;
- Dual-diagnosis services for individuals with co-occurring mental health and substance use conditions;
- Medication-assisted treatment;
- Peer provided recovery support services for addiction and mental health conditions;
- Support services for self-directed care;
- Screening, Brief Intervention, and Referral to Treatment (SBIRT);
- And more.
Click to read the full list of recommendations and supporting data.