In 2008, mental health advocates hailed the Mental Health Parity and Addiction Equity Act as “historic;” putting an end to what Sen. Edward Kennedy called “the senseless discrimination in health insurance coverage that plagues persons living with mental illness.” The law requires most group health plans to offer coverage for mental health and substance use disorders equal to that provided for medical problems. Two years later, the Affordable Care Act extended this mandate by designating mental health and addiction treatment as one of 10 “essential benefits,” and requiring that Medicaid, as well as private individual and small group plans also provide equal benefits for behavioral health and medical services.
Mental health problems are the leading cause of disability in the U.S. and the Centers for Disease Control and Prevention estimate that more than a quarter of adults report having a mental illness at any given time. About half of us will experience mental illness during our lifetime. The intent of the parity legislation is clear; to improve access to desperately needed mental health and addiction services for millions of underserved Americans. Health plans are barred from creating higher deductibles or charging larger co-payments for mental health and addiction disorders treatment. Enrollees no longer have annual and lifetime caps on coverage or face highly restrictive limits on inpatient stays and outpatient visits to behavioral health providers. The Department of Health and Human Services (HHS) estimates that through Medicaid expansion alone, some 32 million individuals could gain access to behavioral health coverage for the first time by 2020.
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