As federal health care reform rolls out over the next few years, many of the currently uninsured children in Texas—1 of every 4 children—will have access to health coverage, including mental health and substance abuse benefits. This is great news. Providing hundreds of thousands of Texas children with increased access to health and behavioral health coverage is a huge step forward to helping our children grow up healthy and strong, physically and mentally—and to helping our state and society prosper.
Yet Texas families may well continue to face significant challenges getting the services they need to address their children's mental health concerns. Coverage doesn't guarantee access to effective treatment, nor does it guarantee there will be health or mental health providers available in their communities that can appropriately address children's mental and behavioral health needs. Texas currently struggles with a mental health workforce shortage, especially in rural areas and among those specializing in children's mental health. Not all providers accept public insurance plans, and some only see families who can pay out-of-pocket. And a family who does locate a provider who accepts their insurance, public or private, still may face challenges securing the treatment known to be most effective and appropriate for their child. Until federal regulations related to health care reform are written, it is unclear what types of mental health services will be covered, and it is possible states will be granted some discretion in establishing minimum benefits within their borders. We need to make sure Texas provides its children and families with access to a comprehensive range of research-based services in order to meet the individual needs of children and youth.
Health care reform will bring coverage to roughly 95% of American children, but some kids (and parents) will remain uninsured in Texas. It is not yet clear the impact health care reform will have on the public mental health system in Texas, which has been the safety net for individuals with no insurance. It is critical the public mental health system continues to serve children who lack health insurance. There may also be opportunities to link children with complex needs and their families with supports and services not covered by insurance plans, such as respite care, in-home psychological services, and wraparound services.
Opportunities exist within health care reform to address many of these issues, but not all. It's up to the state to take advantage of these opportunities and seek out additional ways to fill the gaps that will remain. Mental health is an integral part of a person's overall health, and Texas needs to include mental health promotion, prevention, and treatment strategies in its planning and policymaking.
