Now comes the recovery. At least two workers at the Navy Yard reported that they were standing beside people who were gunned down, one shot in the head. One person said that when he got up from a crouched position, there were bullet holes near the top of the wall. In that situation, I would ask the question, 'why not me'? And I might need someone to help me deal with the trauma or guilt.
I think about the folks who were working at the Navy Yard or other workplaces who have to deal with the aftermath of such tragedies. And while such incidents are rare, it is likely that you are working with people who are struggling with mental illnesses and need help to handle their condition.
Although many large and small group insurance plans include services for some mental-health and substance-use illnesses, there are gaps in coverage. About one-third of those who are covered in the individual market have no coverage for substance-use disorders, and nearly 20 percent have no coverage for mental-health cases, including outpatient therapy visits and inpatient crisis intervention and stabilization, according to the Department of Health and Human Services.
But starting next year, this will change for many workers.
Under the Affordable Care Act, insurance plans offered in the new marketplaces will have to cover a core set of services called "essential health benefits." Included on the list of 10 benefits are mental-health and substance-use disorder services, which include behavioral health treatment, counseling and psychotherapy. Specifically, as part of what's considered preventive services, plans will also cover alcohol-misuse screening and counseling, depression screening for adults and for adolescents, domestic- and interpersonal-violence screening for women, and behavioral assessments for children.
Here are two important points about mental-health coverage under ObamaCare. First, the coverage for behavioral-health services must be generally comparable to coverage for medical and surgical care. Second, plans offered in the marketplace have to cover preventive services without charging customers a co-payment or co-insurance even if you haven't met your yearly deductible. However, the services have to be delivered by a network provider.
The Kaiser Family Foundation noted in a report released this month that benefits will be extended in many cases to cover services typically now excluded, such as mental health. Starting next year, health plans won't be able to deny coverage or charge you more because of a pre-existing health condition, including a mental illness.
We are reminded of the seriousness of mental illness when there's an incident like the one at the Navy Yard. However, this issue should matter to workers and employers more often than just at the time of a tragedy.
Open enrollment in the health-insurance marketplace begins Oct. 1. Visit healthcare.gov to learn more about the behavioral health services offered.
The Affordable Care Act will provide one of the largest expansions of mental-health and substance-use-disorder coverage in a generation, the Obama administration says. I hope that by expanding access to mental-health coverage, we can get people the help they need and in the most severe situations prevent tragedies that result in the loss of life.