ABSTRACT
Health and Mental Health Policies and Programs has been substantially revised so that instructors and students a have thoroughly updated, well-referenced foundation for their study of policies in this essential area of social work practice. This chapter traces recent developments in health care policy, including efforts to undermine the Affordable Care Act through regulatory action, judicial challenge, and legislative repeal. We analyze Medicaid, Medicare, and CHIP, and provide information about how they have been changed due to the Affordable Care Act, state policy efforts, and the ascendance of managed care. Chapter 10 includes not just access to health care but also policies that affect health more broadly, including those shaping the social determinants of health and those affecting the quality and diversity of the health care workforce. The ecological perspective, presented in earlier chapters, provides the foundation for discussion of how the built environment influences individual and population health, and how changes in the built and natural environment may affect outcomes. Potential future changes to health care policy—including Medicaid waivers and work requirements and making Medicare a voucher program—are highlighted, and policy practice strategies social workers can use to influence these debates are provided. To help students understand the context for their own social work practice, there is considerable discussion of state-level differences in health policy. The sections on mental health and substance use disorders have been substantially updated to include discussion of the opioid epidemic, changing attitudes and state policies about drugs and addiction, and recent funding increases in response to growing need. Students are provided with resources and discussion to examine pressing topics in health policy, including suicide prevention, mental health and criminal justice, health disparities, and efforts to control health care costs.
