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The Two-Way
3:06 pm
Fri November 8, 2013

Mental Health Moves Closer To Parity In New Insurance Rules

Originally published on Fri November 8, 2013 7:28 pm

Many health insurers must treat coverage of mental health and substance abuse in the same way they handle treatments for physical illness, according to a new rule issued Friday by the Obama administration.

The rule "breaks down barriers that stand in the way of treatment and recovery services for millions of Americans," Health and Human Services Secretary Kathleen Sebelius said Friday. "Building on these rules, the Affordable Care Act is expanding mental health and substance use disorder benefits and parity protections to 62 million Americans."

The goal of the new rule is to ensure people who need treatment for mental health and substance abuse problems are subjected to the same copays, deductibles and other benefits that apply to patients who need medical or surgical treatments.

The law has limits. For instance, it applies only to group health plans that cover more than 100 workers. Smaller group insurance plans are covered by the Affordable Care Act, which includes similar requirements for parity.

A more complete analysis comes from NPR's Julie Rovner, who will discuss the changes on Friday's All Things Considered. She says the rule "means insurers can't charge someone more for mental health services than for other services. It used to be that plans could, and would, pay 80 percent for medical care but only 50 percent for mental health care."

Julie adds that "under the new rules, plans can't cover fewer inpatient hospital days for mental health or substance abuse treatment than for a physical illness."

Here's a link to Julie's report.

The change implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, also known as MHPAEA. Yes, that means it was approved, and signed into law, in 2008. To its advocates, who include both Republicans and Democrats, the delay has been a rallying call.

"After spending many years advocating in support of the law ... we will continue our work to ensure that we carry out the intent of the law to prohibit discriminatory limits on mental health and substance use services," the group Mental Health America said today.

The Obama administration placed new emphasis on enacting the law as part of its approach to reducing gun violence. In recent months and years, several mass shootings have been carried out by people who were later identified as being in need of mental health care.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.