Being invited to participate on Sean Hannity’s Doctor Summit for FOX News Channel was truly an honor. The topic discussed: The Affordable Care Act (ACA), AKA Obamacare. Doctors from varied disciplines shared their thoughts and observations with regards to how the ACA affects Doctors and their clientele. In addition, a few congressmen and pundits were represented as part of this esteemed panel.
As a Psychotherapist who has been providing counseling for 20 years, as well as a business owner of a busy mental health and wellness counseling practice with a skilled team of therapists of which we each provide individual, couple, and family counseling based in Massachusetts, I will tell you that The Affordable Care Act IS NOT affordable for far too many.
Below you will find my talking points from the lens of this Psychotherapist concerned about how the not so affordable for too many – Affordable Care Act – affects clientele as well as mental health practitioners (whether a Doctorate or Masters level practitioner).
Dr. Karen Ruskin’s Talking Points
- CLIENTS: Many clients will lose access to care and experience decreased options. Even though people are mandated to have mental health coverage, so many cannot afford to go. This is due to the increase in co-payments, increase in deductibles, and increase in premiums.
- An increase in co-payments makes it such that far too many clientele will no longer be able to afford counseling.
- With deductibles increasing, it makes it impossible to go for counseling for far too many. For an example, by the time you meet your deductible so that insurance will finally kick in and pay a portion of your treatment, your year end is up and thus your deductible starts all over again.
- From what I understand based on my research to date, there are no caps on deductibles with the ACA. This makes it unaffordable to receive care! There will be those of whom insurance never ends up covering your treatment at all, because you continue to pay out of pocket endlessly. Here in Massachusetts I have seen how heart breaking it is when a client used to have an affordable deductible in the hundreds, and then their plan increased their deductible into the thousands. This makes it such that far too many cannot afford treatment.
- Forcing people off of their plans with a replacement plan that forces you to find a new Doctor if they are not a provider for your plan is very concerning. This is what the ACA has done. The relationship a client has with one’s therapist is a very unique relationship. Finding a person you trust to expose your inner thoughts, working with a therapist who is a good fit for you, has a style that works for you, your children, your spouse, and your family as well as specializes in what you need counseling for is not always easy to find. Top that off to also include office hours that are a good fit for you is difficult regardless. In Massachusetts where I am based, Romneycare is often compared to Obamacare. Although there are some similarities, there are various significant differences that concerns me deeply. For an example, Romney care provided for and added a public option e.g., Commonwealth Care- government pays part, and MassHealth for the poor. With Obamacare no public plans are being offered. Instead, Obamacare forces people off of their plans with a replacement plan.
- Increased wait time for therapists who accept their plan thus decreased timely care.
- Decrease in choices for therapists who accept your plan.
- MENTAL HEALTH PROFESSIONALS: (Psychologists, Marriage and Family Therapists, Social Workers, . . . )
- Significant decreased reimbursement rates for Doctors and Masters level clinicians.
- Increased mandates that are costly for the mental health professional.
- Decreased reimbursement rates and an increase in costly mandates are significant variables which forces professionals in the mental health industry to; a) close their business, b) drop insurance plans all together and rather require from their clientele upfront payment. Thus, clientele must submit their receipt to their insurance company if they wish to try to receive a percentage of reimbursement, or c) join larger groups instead of working as a solo practitioner small business owner where the increase in costs due to government mandates can be split amongst the group of doctors/therapists to make it affordable to continue in private practice.
- In the 20 years I have been providing counseling, although other industries have increased their payment for services rendered, and cost of living has increased, in the mental health and wellness profession, insurance reimbursement has remained the same. Specifically there has been no increase in payment for services rendered when you accept the contracted rate from insurance companies. Now, with Obamacare, there is a decrease in reimbursement rates (while cost of living continues to increase and Obamacare mandates increase costs for the mental health practitioner) making it impossible for mental health and wellness therapists to keep their lights on. I am not talking about money hungry grubs, I am talking about caring professionals being pushed out of a job they love to do because they will be unable to provide for themselves nor their family with the decrease in reimbursement rates.
If you find these talking points of interest, provided below are my other blog articles discussing Obamacare: