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Tragedy brings focus on mental health agencies

House is slated to vote on health care law this week, which includes mental health service expansion.

The Arizona shooting has focused national attention on the state of mental health care in the United States, and whether government agencies do enough to aid mentally ill people who may become a danger to others. The timing of the attack is coincidental, coming as the House was slated to vote to repeal the health care law this week, which would substantially expand mental health services.

Suspect Jared Loughner has been categorized as "mentally unstable" by law enforcement officials in the wake of the attack on Rep. Gabrielle Giffords, D-Ariz., and constituents gathered at a Tuscon grocery store Saturday. Reports say Loughner was kicked out of Pima County Community College in October after a series of disturbances frightened classmates and instructors.

Although little is known about whether Loughner received any mental health services and if government agencies failed to get him help, Mental Health Association CEO David Shern says the health care law Republicans are working to repeal would bring improvements to potential care.

Shern said last year's overhaul strengthened a 2008 law that required employee-sponsored insurance to give equal coverage for mental health treatment, but it does not apply to employers with fewer than 50 employees. The health care law goes further, requiring plans on insurance exchanges that are slated to open in 2014 and potentially be open to employees at businesses with fewer than 50 employees, to provide equal coverage to mental health issues.

"When exchanges are operating, it will increase mental health coverage availability to individuals who will need them," said Shern. "It's a piece of good news [that will] ultimately be helpful in the long term."

The law also requires insurance companies to provide preventive care free-of-charge for beneficiaries, including mental health screenings, which Shern says would vastly improve the identification of mental health problems, especially among teenagers who Shern says often go untreated for years.

Another provision of the health care law that could expand mental health treatment is the elimination of lifetime limits for insurance plans. Phoenix-area licensed professional counselor Lisa Bravo said severely mentally ill people can easily "cap out" on their policies.

While mental health services are generally administered on the state level, the federal government plays a significant role through the Medicaid program. The health care law substantially expands the Medicaid program in 2014, expanding it to include people at 133 percent of the federal poverty line.

In Arizona, that expansion could be key, as the state cut mental health services not funded by the federal government last year in an effort to eliminate budget deficits.

"We're just reeling from the withdrawal of services," said Phoenix-area lawyer Charles Arnold, who litigated a case challenging the lack of mental health services provided in Arizona for nearly 30 years.