Today, addiction and mental health provider and consumer organizations all over the country won a resounding victory as President Obama signed landmark health care legislation that included many of the principles and provisions advanced by the Coalition for Whole Health. 
 
Today's historic bill signing ceremony capped a seventeen year effort to bring treatment of diseases of the brain in line with the treatment of diseases of the body and built on the foundation laid by the field's historic parity victory.  When the law is fully implemented, 32 million Americans who are uninsured today will have access to health insurance coverage that includes mental health and substance use disorder treatment services at parity.
 
The Patient Protection and Affordable Care Act was approved by the House on Sunday; the Senate passed the same bill on December 24, 2009.  A package of changes to the bill was also approved by the House on Sunday and is expected to be approved in the Senate by the end of the weekend.  If no changes are made to the corrections package, it will go to the President's desk for his signature. 
 
Timeline of key provisions of interest to the those in the addiction and mental health fields that became law today:
 
Within the First 6 Months - 1 Year of Enactment
 
·     Immediate access to insurance for uninsured individuals with pre-existing conditions (including MH/SUD)
 
·    Provides small business tax credits including up to 25% credit for small not-for-profits
 
·    Eliminates pre-existing condition exclusions for children
 
·    Prohibits rescissions
 
·    Covers first dollar preventive health services
 
·     Extends coverage to dependent children up to age 26 who are uninsured
 
·     Ensures Medicaid flexibility for states
 
·     Strengthens the health care workforce - expands and improves low-interest student loan programs, scholarships, and loan repayments
 
·      Prohibits lifetime limits
 
2014
 
·    Establishes health insurance exchanges
 
·    Requires MH/SUD as part of the essential benefits package in exchange plans
 
·    Requires exchange plans to comply with the Wellstone Domenici parity law
 
·    Reforms health insurance regulations
 
·     Prohibits insurers from excluding coverage for treatments based on pre-existing health conditions
 
·     Limits the ability of insurance companies to charge higher rates due to health status, gender or other factors
 
·     Allows premiums to vary only on age (no more than 3:1), geography, family size, and tobacco use
 
·     Increases Medicaid eligibility up to 133% of poverty
 
·     Newly eligible individuals (parents and childless adults otherwise ineligible for Medicaid) will be enrolled in a "benchmark" plan that includes MH/SUD at parity
 
·     Prohibits annuals limits
 
Additional Key Provisions
 
SUD/MH Workforce Development Funds
 
·     Includes a loan repayment program for individuals practicing pediatrics, child and adolescent MH/SUD services
 
·     Authorizes grants to higher education institutions for MH/SUD professionals
 
·     Priority will be given to institutions in which the training focuses on the needs of vulnerable groups, including individuals with MH & SUD and where applicants have demonstrated familiarity with evidence based methods in child and adolescent mental health services including SUD prevention & treatment
 
·     $8M is authorized for social work
 
·     $12M for graduate psychology
 
·     $10M for professional child and adolescent MH/SUD
 
·      $5M for training in paraprofessional child and adolescent work at state-licensed NFP and for-profit organizations
 
Prevention
 
·      In a section authorizing community health team grants aimed at supporting medical homes, the bill includes a provision to include SUD prevention, treatment and MH service providers as eligible grantees
·      Substance use disorders are listed as a national priority in the report to be provided to Congress and the President by  7/1/10 by the National Prevention, Health Promotion and Public Health Council
·      Requires SUD/MH services be provided at school-based community health centers
·      Preference will be given to applicants who demonstrate the ability to serve communities that have evidenced barriers to primary health care & mental health & substance use disorder prevention services for children & adolescents; as well as populations of children & adolescents that have historically demonstrated difficulty in accessing health & mental health & substance use disorder prevention services
 
·      Permits state or local health departments receiving grant funds through a Department of Health and Human Services  (HHS) public health grant program, administered through the Centers for Disease Control and Prevention, to enter into contracts with MH/SUD providers and screening activities may include MH/SUD
 
Inclusion of relevant MH/SUD Agencies in Federal Workgroups
 
*     Includes an HHS education and outreach campaign on the benefits of prevention; section contains a requirement that the campaign disseminate information about the preventive work done by the Substance Abuse and Mental Health Services Administration (SAMHSA)
*     As part of the Medicaid "State Plan Option Promoting Health Homes for Enrollees with Chronic Conditions" program, directs states to consult and coordinate with SAMHSA in addressing prevention & treatment of MH/SUD
 
·     Includes SAMHSA as an agency in the "Interagency Working Group on Health Care Quality"