The Issue

In 2008, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) became law.  This law prohibits discrimination in health insurance coverage of substance use disorder (SUD) and mental health (MH) benefits.  113 million people have gained the protections of the federal parity law. Continued work is needed to ensure plans are complying with the requirements of the law and that people with MH and SUD service needs can access the care they need.

Current Initiatives

National
  • Co-chairing and coordinating the Coalition for Whole Health to ensure the Affordable Care Act is well implemented for people with mental health and substance use disorder service needs.
  • Working with the Conrad Hilton Foundation to examine the impact of the federal parity law on coverage and access to screening and brief intervention services for youth.
New York City and State
  • Ensuring all covered New York health insurance plans meet parity requirements

Policy Recommendations

  • Vigilant parity enforcement: The federal Department of Health and Human Services (HHS) and states should work closely together to ensure that coverage meets the parity and anti-discrimination requirements of the Affordable Care Act, including collecting the data required to ensure compliance and quality.
  • Aggressive parity enforcement: Federal and state regulators should aggressively and transparently enforce the federal parity law, MHPAEA.  HHS should also issue a parity analysis framework for regulators, consumers, and others that explains with specificity how to apply the parity requirements to covered services and medications, financial requirements/cost sharing and both quantitative and non-quantitative treatment limits.  Outcomes of MHPAEA compliance investigations should be made available on Department of Health and Human Services and Department of Labor websites.
  • Transparent health plans: HHS should require that plans make readily available on web sites and otherwise their coverage for MH/SUD, providers of MH/SUD services in their networks, and medical necessity and medical management criteria for MH/SUD, as well as for other conditions for parity comparison purposes.
  • Clear and strong parity regulations: Federal regulators should promptly issue additional guidance on the application of the federal parity law to Medicaid managed care, Medicaid Alternative Benefit Plans, and CHIP.  Federal and state regulators should continue working to ensure that parity is fully implemented and enforced in these programs.
  • Compliant Essential Health Benefits packages: HHS should conduct a review of all EHB packages to ensure that they meet all of the requirements of MHPAEA and the ACA, and, when problems are identified, work with federal and state partners to enforce those requirements.

Learn More

To learn more about this issue, visit our Parity and Health Care Access Resources.

To learn more about LAC’s impact, see our Accomplishments.

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