The Potential Effects of the ACA Repeal on Mental Health

I’m worried about ACA repeal since Congress and the president announced it was one of their top things on their to-do list. I’m concerned because of the effect it would have on mental health.

Essential 10 Health Benefits

Under the ACA, mental health and substance abuse disorder became a fundamental part of the “essential 10 health benefits” for people buying health care on a public exchange. This means that insurance companies such as Aetna, Anthem, and United Health Group cannot make mental health an individual commodity for consumers to add on their own. Also, the law made it difficult for insurance companies to deny coverage to people with pre-existing conditions, allowed adults to stay on their parents’ health insurance until the age of 26, and provided mental health parity through the expansion of Medicaid (Japsen, 2017).

Mental Health Treatment has Risen

A recent CDC report showed that uninsured adults with severe psychological distress dropped from 28.1 percent in 2012 to 19.5 percent in the first nine months of 2015. Also, studies have shown that mental health treatment has risen, especially among young adults. This indicates that the persistent treatment gap may be closing as a result of the ACA (Lapowsky, 2017).

Progress could be Undermined

Researchers fear that with the ACA repeal, without a replacement, could undermine the progress that has been achieved in mental health. Richard Frank, a health economist at Harvard Medical School, says that an estimated 1.8 million of the 21 million covered under the ACA are receiving mental health services and subsidies. This extends to around $5.5 million in coverage, which would vanish if the law is revoked (Lapowksy, 2017).

Targeted Interventions do not Necessarily Work

Another concern is that Congress members are pushing for targeted interventions towards substance abuse and mental health rather than broad-based coverage (Lapowsky, 2017). The problem with this action is that it assumes that people with mental health and substance abuse problems are separate issues rather than issues that contribute to each other. Furthermore, mental health care requires comprehensive coverage instead of targeted intervention because mental illness and substance abuse are often secondary symptoms of a deeper problem. More fragmentation of the healthcare system will cause adverse outcomes for mental health care.

Insurance Companies could stop Mandating Coverage

Other fears include that the potential new legislation could stop mandating insurance companies to cover individuals with pre-existing conditions (Grohol, 2017). This is a blow to mental health because mental illness is a chronic ailment that people don’t receive out of the blue.


I’m scared of the potential new legislation because it will affect me. An example is if the law changes and insurance companies are not required to cover pre-existing ailments, I’m screwed. I may have difficulty finding an insurance provider that offers mental health care and two, even if there are providers who offer it, it will likely go back to the status quo and be expensive. I don’t want that to happen, and I doubt many others do as well.


Grohol, John M. (2017, Jan. 14). How the repeal of obamacare will impact people with mental illness.


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Japsen, Bruce. (2017, Jan. 13). Psychologists to trump: Don’t repeal aca’s mental health coverage.


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Lapowsky, Issie. (2017, Jan. 15). Obamacare’s demise is a looming disaster for mental health. Wired.

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