Insurance, Social Services Prepare for Health Care Changes

Last week, the Supreme Court upheld the Patient Protection and Affordable Care Act, ensuring that all Marylanders will continue to benefit from this law.

Already, this landmark legislation is having a positive impact in the state, according to Congressman Steny Hoyer. In a statement on the court’s decision, Mr. Hoyer stated that at least 46,000 young adults under 26 are now receiving coverage through their parents’ insurance plan, and nearly 1,000 previously uninsured residents with pre-existing conditions have gained coverage.

Seniors are saving on their prescription drugs, including over 52,000 seniors in 2011, and over 10,500 through May of this year, Mr. Hoyer said. In addition, over 550,000 Medicare beneficiaries have received free preventive services or a free annual wellness visit with their doctor, and over 1.1 million people with private health insurance gained preventive service coverage with no cost-sharing last year.

Moreover, over 140,000 Marylanders covered by private insurance plans will benefit from nearly $28 million in rebates from insurance companies this summer.

“I’m pleased that so many people in Maryland and across the country are benefiting from health care reform already, and I will continue working to implement this legislation so that all Marylanders have access to affordable, quality health care,” Mr. Hoyer said.

Maryland is already ahead of the game, according to Jay Duke of Leonardtown. Mr. Duke of Waring-Ahearn Insurance serves on the committee guiding how Maryland incorporates doctors, insurance brokers and nonprofit care providers into the new health care laws.

He doesn’t downplay the learning curve of some of the new provisions. Two years ago, he offers as an example, insurance brokers could not present Medicaid provisions. But now, under some provisions of the Affordable Care Act, insurance agencies can elect to offer those options.

Similarly, he said, the social service agencies will face a similar learning curve with the broadening options being made available.

Maryland aggressively approached the transition early on, Mr. Duke said.  “Maryland is a leader in incorporating all of the participants needed to address ACA.”

For behavioral health organizations like Walden Behavioral Health, the Affordable Care Act will mean important changes to what services are available to people with mental health and substance abuse problems. The Act includes parity provisions, which result in making mental health and substance use health problems considered on a par with primary care health issues. That means that access to prevention, treatment , prescriptions, rehabilitative, and wellness services for behavioral health issues should become more available, Walden stated. This will be especially a benefit to people who are uninsured or underinsured or are part of groups that have a difficult time getting healthcare.

ACA also encourages primary care, mental health and addiction services to work together.

“Walden is already working on that, and we hope to do more,” said Kathleen O’Brien, Walden’s executive director. “Walden recently received a state Community Health Resources Commission grant for this kind of collaboration. We are working with Medstar St. Mary’s Hospital and Greater Baden Medical Services to provide integrated services. We hope that locating screening and assessment for behavioral health issues in primary care settings will lead to more people getting help. We know that the earlier a person can get help for behavioral health conditions, the easier the journey to recovery.

“As Walden’s CEO, I have been involved on many Health Care reform committees in the state and serve as a member of the State Drug and Alcohol Council. I recently was appointed to work on a merger of the Council with the State Mental Health Council. As an organization, Walden has also attained CARF accreditation, added mental health services and streamlined our processes to be ready for healthcare reform.”