Affordable Care Act and Behavioral Health Services: Special Section Editor’s Note

The Patient Protection and Affordable Care Act (ACA) paves the way for substantial changes in the coverage and provision of behavioral health services to prevent and treat substance abuse, mental disorders, and co-occurring disorders. For example, the ACA promotes new programs and tools, such as home health, interdisciplinary care teams, the broadening of the Medicaid Home and Community-Based Services option, co-location of physical health and behavioral health services, and collaborative care. In addition, the act offers opportunities to insure many more people, provide coverage for previously unreimbursed services, integrate care using new information technology tools and treatment teams, and implement evidence-based interventions. The main motivation behind the ACA is to design a comprehensive market-based health reform (see Fig. 1 for the timeline of ACA implementation). The law intends to increase the number of insured people by requiring those who can afford to do so to purchase health insurance or pay a penalty (individual mandate). For those who cannot afford the premiums, it provides tax subsidies to enable individuals to purchase individual insurance policies through the Exchanges. The ACA prohibits health insurers from discriminating on the basis of preexisting conditions or from imposing lifetime limits on coverage. In addition, the law expands Medicaid coverage to individuals with incomes below roughly 133% of the federal poverty level. The ACA also provides funds that are targeted at population health. For example, the Prevention and Public Health Fund is authorized to disburse $15 billion over 10 years. There are also a number of smaller programs and community interventions that promote healthy lifestyles for older adults, childhood antiobesity projects, and Community Transformation Grants to State, local, and tribal agencies for preventive health activities. Other public health issues that the act provides are funds to include discrete, evidencebased preventive services as well as school-based health centers and oral health campaigns. A considerable amount of research has been conducted to analyze the impact of the Affordable Care Act on certain population subgroups such as children, elderly, or Medicaid beneficiaries. However, there is still a need for further research on the ACA and the population utilizing behavioral health services because people with serious mental illnesses (SMIs) and/or substance use disorders (SUDs) face extra challenges and possible disengagement from health care systems. How the ACAwill affect coverage and provisions of behavioral health services are critically important for this population. This special section of The Journal of Behavioral Health Services & Research brings together a series of articles on the Affordable Care Act and behavioral health services. The first article by Beronio et al. sets the stage by discussing how the coverage expansions in the ACA build on and enhance the protections against discriminatory limits and cost-sharing established in the Mental Health Parity and