Over the past decade, there have been significant expansions in policies that support low-income working families, such as refundable tax credits, health insurance, child support enforcement, child care subsidies, and nutritional supports. These programs help hard working families who struggle to meet basic needs due to low wages, irregular hours and lack of benefits. However, this safety net is incomplete. CLASP advocates for improvements in individual programs and in the service delivery system to help ensure low-income families have the support they need to stay employed and provide for their families.
Apr 25, 2016 | PERMALINK »
It’s Final: Parity in Medicaid
Centers for Medicare and Medicare Services (CMS) recently finalized long awaited rules for mental and behavioral health parity in Medicaid, marking a significant milestone for access to mental health care. Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008, setting new guidelines for patients’ access to mental and behavioral health services. Rules for commercial insurance plans were finalized in 2013 and now comparable rules have been finalized for Medicaid.
We commend CMS for finalizing rules that provide an important step forward for low-income families that need mental health treatment or substance use treatment in order to succeed in work or school and to be healthy parents to their young children. Access to mental and behavioral health services are critical supports for many low-income Americans, including mothers with maternal depression.
Depression is widespread among poor and low-income mothers, including mothers with young children. One in nine poor infants lives with a other experiencing severe depression and more than half live with a mother experiencing some level of depressive symptoms. While depression is highly treatable, many low-income mothers do not receive treatment – even for very severe levels of depression. Indeed, more than one-third of low-income mothers with major depressive disorder get no treatment at all. Unfortunately untreated maternal depression is damaging to children, particularly young children, placing at risk their safety and cognitive and behavioral development. In addition to the health complications caused by depression, such as frequently occurring with comorbid medical conditions, depression is also association with unemployment or underemployment.
For all these reasons, the new rules for parity in Medicaid stand to make a significant difference in the lives of low-income mothers and families. CLASP is particularly pleased to see the following elements included in the final rule:
- Medicaid plans will not be able to apply different treatment limits to mental or behavioral health than are applied to medical/surgical treatments. For example, if a plan allows an unlimited number of doctor visits based on medical necessity the plan must also allow unlimited number of mental health visits as deemed medically necessary.
- All Medicaid enrollees will benefit from the parity rules, regardless of whether they receive Medicaid through traditional "fee-for-service" or a Managed Care Organization (MCO). If a state uses MCOs to provide Medicaid benefits, all MCOs must ensure compliance with the new parity rules regardless of whether mental health benefits are administered separate (often called a “carve out”) .
- MCOs must share, upon request, their medical necessity criteria with any enrollee, potential enrollee, or contracting provider. Furthermore, MCOs must make available the reason for any denial of reimbursement or payment for services for mental health/substance use disorder. These two provisions are critical to the first item listed above, ensuring that mental health/substance use disorder benefits are available with no more restrictive criteria than comparable medical/surgical benefits.
States have until October 2017 to comply with the new rules. Given the potential for positive impact these rules have on low-income families, we urge states to consider a speedier implementation timeline.
Work Support Strategies: Streamlining Access, Strengthening FamiliesThe Work Support Strategies initiative provides a select group of states the opportunity to design, test, and implement more effective, streamlined, and integrated approaches to delivering key supports for low-income working families. READ MORE »
Advancing Strategies to Align Programs
The Advancing Strategies to Align Programs (ASAP) initiative helps state advocates promote increased enrollment in work support programs, particularly Medicaid and SNAP, through program alignment and information sharing. It draws on the lessons of the Work Support Strategies initiative.READ MORE »
- Cemeré James | Apr 04, 2016 Work Support Strategies Initiative: 12 Lessons on Program Integration and Innovation
- Amy Ellen Duke-Benfield | Dec 15, 2015 Bolstering Non-Traditional Student Success: A Comprehensive Student Aid System Using Financial Aid, Public Benefits, and Refundable Tax Credits
- Sep 10, 2015 Work Support Strategies Forum: Next Steps in Health and Human Services Integration after King v. Burwell
- Elizabeth Lower-Basch | Jul 17, 2015 Comments on Discussion Draft of TANF Reauthorization Bill
- Olivia Golden | Jun 25, 2015 Testimony by Olivia Golden on Work Incentives and the Safety Net
- May 04, 2016 TANF and the First Year of Life: Making a Difference at a Pivotal Moment
- National Disability Institute | Jan 19, 2016 SNAP Time Limits: What Providers Should Know About the Impact on Individuals with Disabilities
- Cemere James | Apr 04, 2016 Work Support Strategies Initiative: 12 Lessons on Program Integration and Innovation
- Mar 16, 2016 Testimony for the Record for Hearing on Getting Incentives Right: Connecting Low-Income Individuals with Jobs
- Helly Lee | Mar 10, 2016 Comments to the USDA Food and Nutrition Service on Proposed SNAP Photo EBT Card Implementation Requirements