After gaining interim final rule on July 14, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) has officially been enforced by the federal government, making health insurance coverage for mental health and addiction disorders parallel to coverage for other medical benefits. With the support of Congressman Patrick Kennedy (D) and former Congressman Jim Ramstad (R), the federal mental health parity law gained passage in the House. MHPAEA requires insurance companies that provide mental health benefits to make these benefits no different from the coverage for other medical benefits–including similar co-pays, deductibles, lifetime/annual limits, treatment limits, and out-of-network benefits–as of July 1, 2010.
The parity law initially went into effect on October 3, 2009 but had not received its regulations until this time. With the implementation of the Obama Administration, the law’s provisions will allow millions of Americans to access much-needed recovery services and is intended to eliminate any discrimination against individuals seeking coverage for mental health and addiction treatment. Now, American’s insurance plans must guarantee them access to these benefits as promised to them by law. Passage of the law took the diligence and dedication of Reps. Kennedy and Ramstad, as well as other key sponsors of the bill, including the late Ted Kennedy (D), Sen. Chris Dodd (D), and former Sen. Pete Domenici (R).
Although the MHPAEA is being lauded by the behavioral health community, further changes are still needed to help fully realize the Act’s good intentions of making mental health and addiction services accessible to all Americans. Even though the Act requires that insurance companies update their mental health coverage as of July 1, most plans’ new policies will not begin until January 1, 2011 but will be regulated under the Act’s interim ruling until that time. Also, the MHPAEA does not require that insurance plans offer mental health and addiction disorder coverage and only applies to those plans that already do offer these provisions. The MHPAEA is most relevant to insurance plans offered by large employers, where mental health benefits are usually included. The Affordable Care Act, having recently gained passage as well, will help patch the holes in MHPAEA’s law by requiring insurance plans offered in exchange (which are usually purchased by small businesses) as well as Medicaid to include mental health and substance abuse coverage by 2014.
Secondly, some behavioral health organizations are concerned that equality in insurance policy does not necessitate equality in access to care or how some insurance providers are treated compared to others. In regards to future legislation, more mental health and addiction resources will need to become available, and prevention and intervention strategies will need to be implemented much sooner. Discovery of at-risk individuals needs to be improved and regulated by more professional standards.
Usually, law enforcement is the first to interact with substance abusers or those suffering from mental disorders, and they cannot adequately evaluate the level of care needed for these individuals and serious mental illnesses go undiagnosed. Some mental health and addiction treatment centers have suggested the creation of a mental health expert who would work in conjunction with law enforcement and provide evaluation on the scene of these encounters. Furthermore, more psychiatric personnel are still needed to effectively serve patients in a timely manner and prevent long waiting lists and obstructing care. The MHPAEA is a major step forward in addiction and mental health progress, but more changes still need to be made in coming years following the start of this mental health revolution.
Individuals who wish to learn about their new benefits under their insurance policies can call the U.S. Department of Labor at 1-866-444-EBSA.
Sources: Medical News Today, Coalition Hails Enforcement Of Parity Law – Mental Health America, July 8, 2010
The Journal Times, Janine Anderson, Mental health parity panelists: insurance is not enough, June 30, 2010