Kadner: The mentally ill, once again, will be among first hurt

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Detainees at Cook County Jail wait to be processed on Dec. 24, 2014. The Cook County Sheriff’s department is screening all detainees for mental illness and PTSD. | Jessica Koscielniak/Sun-Times

Follow @csteditorialsIf the Affordable Care Act is repealed by the Trump administration and the U.S. Congress, people suffering from mental illnesses will be among the first victims of those cuts.

Whenever there’s a mass murder or sensational violent crime and the person suspected of the offense has a history of mental illness, the public immediately wants to know if that person has received proper treatment and, if not, why not.

OPINION

Of course, the vast majority of people suffering from mental illnesses commit no crimes. They live productive lives, and you likely don’t even realize they are working or living next to you, especially if they are under a doctor’s care.

Yet, we know that about one-third of the people in Cook County Jail have been diagnosed with a mental ailment and Cook County Sheriff Tom Dart has said the jail has become the largest mental health care institution in Illinois.

Also, about 18 percent of the people in Illinois prisons have been diagnosed with a serious mental illness.

More of the mentally ill are landing in jails and prisons in part because city and state mental health care hospitals and clinics have been closed and funding for mental health care programs has been cut.

But in recent years the Affordable Care Act, also known as Obamacare, has expanded access to health insurance for those suffering from mental ailments.

The Affordable Care Act made it illegal for insurers to deny coverage to people suffering from pre-existing conditions, an excuse that often was used to deny insurance to people suffering from mental illnesses.

In fact, I once wrote about widow of a firefighter who personally paid for her children’s therapy after their father died of a heart attack in front of the kids.

When she applied for a family health insurance policy she was denied coverage by one of the largest insurance companies in the nation because her children had been treated for a mental illness and were therefore considered a high risk for suicide.

Officials for the insurance company told me it really didn’t matter that the kids had never suffered from a mental illness and that the therapy was only precautionary (good parenting) because the company had certain protocols it had to follow.

I mention all of this just to give you an idea of the difficulties people suffering from real mental ailments faced when it came to getting insurance before the Affordable Care Act.

“It would be devastating” for the mentally ill if the Affordable Care Act were eliminated, says Mark Heyrman, chair of public policy for Mental Health America of Illinois.

Heyrman noted that President-elect Trump has indicated he may retain two key provisions of the Affordable Care Act key to those suffering from mental ailments. Trump has said he would allow children to remain on their parent’s health insurance policies up to the age of 26 and prevent insurance companies from denying coverage due to pre-existing health conditions.

But Heyrman noted Obamacare also expanded access to Medicaid for the poor, increasing its rolls by more than 20 million in 31 states. It also provided treatment for substance abusers.

Still, the National Alliance for Mental Illness (NAMI) released a report this week that indicates a gap between health insurance coverage for the coverage of mental health and substance abuse conditions and that of other medical conditions.

The report reveals that one in four people did not have a mental health therapist in their insurance network. Also, people were 2.5 times more likely to have problems finding a psychiatric hospital that would accept their insurance compared to other types of hospital care.

I realize people believe the Affordable Care Act is a failure. But those suffering from mental illness, as always, suffer disproportionately when the government starts making cuts.

Heyrman, like President Obama, is taking the optimistic view that Trump, once he realizes the many benefits of the Affordable Care Act, will seek to preserve many of them. But even if a new enlightenment has altered Trump’s views, the Republican Congress may have other ideas.

Email: philkadner@gmail.com

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