6/14/19 - Legal Promise of Equal Mental Health Treatment Often Falls Short

Each day, evidence from around the nation displays the lack of equality in mental health treatment vs. traditional healthcare. Following the 2008 Mental Health Parity and Addiction Equity Act, large group health plans were required to provide benefits for mental health as it would with physical healthcare. Again in 2010 with the passing of the Affordable Care Act, small group and individual health plans were required to cover mental health services at a level comparable with medical services. That is not to mention that in 2016, parity rules were applied to Medicaid managed-care plans. Although seemingly a win for mental health, how have these pieces of legislation played out since their passing?

In February, researchers at the Congressional Budget Office found that private insurance companies are paying 13% to 14% less for mental health care than Medicare does. Even the insurance industry’s data shows an ever-growing gap between coverage of mental and physical care in hospitals and skilled nursing facilities. A 2017 report found that an office visit with a therapist is five times as likely to be out-of-network, making them more expensive than a primary care appointment.

The problem here comes from a misinterpretation of criteria by insurers. They pay enough to stabilize patient’s conditions, but not enough to improve their underlying illness. This lack of criteria for what makes something medically necessary leads to long processes in and out of mental health care programs with little to no insurance coverage, exacerbating the already identified illness.


Read the article from khn.org here.

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