Health Policy Analysis: ACA Effectiveness, Veteran Care, and Reforms

This report critically analyzes the effectiveness of current health policies, particularly focusing on the Affordable Care Act (ACA) and its impact on individuals with substance abuse and mental illness, alongside the care provided to military patients and veterans through the Military Health System (MHS) and Veterans Health Administration (VHA). The report evaluates the ACA's benchmarking system and its shortcomings in providing adequate coverage for mental health and substance abuse treatments, citing violations of parity criteria and inadequate monitoring. It also assesses the effectiveness of MHS and VHA policies, examining their roles in providing healthcare to military personnel and veterans, particularly concerning Post Traumatic Stress Disorders (PTSD). The report concludes by identifying areas where reforms are needed within these systems to improve services for veterans and ensure comprehensive healthcare coverage.

Running head: LEADERSHIP IN HEALTH POLICY
Leadership in Health Policy
Name of the Student
Name of the University
Author note

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1) Regarding the care of patients with substance abuse/mental illness: Are current ACA or
proposed legislative policies effective in addressing needs of those with substance abuse,
and/or mental illness--for example, what are the benchmarks for effective intervention in
these areas, and how do states, and US system rank in meeting these benchmarks? Cite at
least two policy areas that are working, or if not, could be revised or proposed to better
meet needs of these population groups?
In 2010 the US government announced the Patient Protection and Affordable Care Act (ACA)
that enable the opportunity to expand health insurance coverage for everyone involving both
private insurance policies and Medicaid. The ACA aimed to provide benefit for millions of
citizen even for mental health and substance use also known as MH/SU (Ligon, 2013).
Apart from that, in 2014 the ACA includes new benchmarking system for all the state
government, which was aligned with the Mental Health Parity and Addiction Equity Act
(MHPAEA) including benchmarking system to cover mental health and substance abuse disorder
services including behavioral health treatment, counseling and psychotherapy
(Thehortongroup.com., 2018).
In spite of all these planning and enforcement the majority of state insurance plans breach the
ACA benchmarking criteria for addiction treatment coverage. According to a new report from
The National Center on Addiction and Substance Abuse (NCASA), the state benchmark plans
failed to provide adequate coverage. In the research report on effectiveness of benchmarking
system in ACA. Vuolo and CASA researchers showed that, ‘for that states require, failed to meet
the minimum benefits of the benchmarking standard for effective treatment’
(Centeronaddiction.org., 2018). The report also showed that 18 % of state level insurance plans
violated parity criteria, 31 % of plans contained potential parity violations, 88% of plans lacked

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enough features to appraise the parity compliance and liberal coverage of addiction benefits or
metal issues. . The ACA did not progress the federal mental health system while ‘simply
expanded unproductive, incompetent policies that failed to deliver treatment’ up to the
benchmark level. As per annual report on collaborative activities and expenses of state and
federal government, the inadequate monitoring and loose enforcement has been fount the major
cause of these dilemmas. Researchers said that the states should review and revise their
benchmark plans to comply with the federal level ACA requirements to ensure comprehensive
coverage the substance use and mental disorder treatments.
2) Regarding the care of military patients and veterans: Are Current MHS and VHA
policies effective in addressing the needs of military service members and veterans? If yes,
cite two examples of effectiveness; if no, what top two reforms are needed within these
systems to improve services for veterans?
The Veterans Health Administration (VHA) organizes and provides the integrated governance
formation including the appropriate medical components for the Armed Forces. These essential
components can offer pertinent care aligned with the policies of Veterans Benefits
Administration along with the National Cemetery Service of the Department Of Veterans
Affairs. On the other hand, the Military Health System (MHS) provides the resources, health
professionals, and direction that are necessary to promote the health of the military personnel,
being US‘s largest health care organizations. It is currently providing healthcare services to 9.6
million military, civilian, and contract personnel in the MHS setting (Institute of

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Medicine.,2013). The mission of MHS is to provided medical services for the Armed Forces and
their family members and other beneficiaries who are considerable under the DoD, especially
during and after any military operations.
The mission of the Veterans Healthcare System or VHS is to serve the veterans by providing
primary and specialized care, and associated services for medical and social support. Focusing
on the Post Traumatic Stress Disorders (PTSD) and other ‘after war’ mental health issues,
Department of Defense (DOD) and the Department of Veterans Affairs (VA) are covering the
majority of the health care systems (Grimes, 2012). The MHS and VHA together provide
infrastructure of 63 inpatient facilities with 1087 dental, medical and veterinary clinics for
131,000 military persons. The federal defense budget of 2010 allocates $38.7 billion for
providing health reimbursement to armed forces personnel and their dependents while serving
9.1 million eligible beneficiaries (Rand.org., 2018).

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References:
Centeronaddiction.org. (2018). The National Center on Addiction and Substance Abuse Anual
Report. Retrieved from
https://www.centeronaddiction.org/sites/default/files/2017%20The%20National
%20Center%20on%20Addiction%20and%20Substance%20Abuse_Annual
%20Report_0.pdf
Grimes, W. B. (2012). Merging the Military Health System (MHS) and the Veterans Health
Administration (VHA) into a Single Governance Structure. ARMY WAR COLL
CARLISLE BARRACKS PA.
Institute of Medicine. (2013). Returning home from Iraq and Afghanistan: Assessment of
readjustment needs of veterans, service members, and their families. National Academies
Press.
Ligon, K. (2013). The Affordable Care Act and Mental Health.
Rand.org. (2018). Military Health and Health Care. Retrieved from
https://www.rand.org/topics/military-health-and-health-care.html
Thehortongroup.com. (2018). Mental Health Benchmarking | The Horton Group. Retrieved from
https://www.thehortongroup.com/resources/mental-health-benchmarking

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