How insurance gets away with denying mental health coverage, part 1

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Back in 2008, the Mental Health Parity and Addiction Equity Act (or Mental Health Parity Act) passed Congress and required group health insurance covering mental health to do so in a way similar to how other treatments were included, which put mental health coverage on par with traditional healthcare coverages.

Or at least it was supposed to.

The problem is that the Act, while well-intentioned, has no actual rules for anyone to follow. All while the law, as it's written, continues to broaden its reach under the Affordable Care Act (aka "Obamacare") as new portions of that law continue taking effect.

The Good

The simplest part of the Mental Health Parity Act, which was also its least controversial, is the requirement that any restrictions on mental health coverage be on par or less restrictive than those for standard healthcare coverages offered. In other words, if a health plan doesn't restrict doctor's visits for treatments, it also cannot restrict mental health visits for treatment.

The Bad

Yet the rest of the requirements, including enforcement of the parity rules, are not well-defined and have yet to be truly implemented. The federal Substance Abuse and Mental Health Services Administration, charged with creating the rules under the Mental Health Parity Act, says they're "ready to produce" a final regulation, but will not give a time frame for its release.

The Ugly

Given that health insurers are required to provide plans for exchanges at the state and federal level by October and that those plans must be in keeping with the Parity Act's rules, it's likely that those insurance plans will not include mental health coverage at all this year in order to avoid last minute reshuffling.

In The Atlantic, journalist Judith Graham lists several of the mental health parity regulations that are stalled in neutral awaiting final regulations. These include the scope of services covered, medical management strategies, and the aforementioned enforcement.

In Part 2 of this article, we'll look at why this is only half of the problem.

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