LAC Director Testifies Before IOM on Essential Benefits Package

Jan. 14, 2011

The Institute of Medicine held a series of meetings this week to develop recommendations to the Secretary of Health and Human Services on how to define “essential health benefits” under the federal health reform law. The institute asked Legal Action Center Director/President Paul N. Samuels, who also serves as the co-chair of the Coalition for Whole Health, to present its recommendations concerning the development of the required mental health and substance use disorder benefits in the essential benefits package.

In his testimony, Mr. Samuels emphasized the need for a broad, robust mental health and substance use disorder benefit in health reform. Specifically, he strongly encouraged good coverage for and access to:

• The full range of quality mental health and substance use disorder prevention, treatment, rehabilitation, and recovery support services;
• The clinically appropriate amount, duration, and scope of care;
• All services, interventions and strategies to help people avoid disease and to help people with these illnesses achieve and maintain long-term wellness;
• Ongoing supports to help people manage their disease throughout their lifetimes;
• Services for children and families; and
• Services that are culturally appropriate.

The federal health reform law requires that all qualified health plans in the small group and individual markets – as well as coverage made available through the Medicaid expansion – include certain essential benefits, including mental health and substance use disorder benefits at parity with other health coverage. The Congressional Budget Office estimates that the essential health benefits protections of the law will apply to approximately 45 million Americans when fully implemented.

More information on the meetings is available here; you can view a copy of Mr. Samuels’ presentation at this link.

 

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