Progress in Mental Health Parity, Yet Challenges Remain
Table of Contents
- 1. Progress in Mental Health Parity, Yet Challenges Remain
- 2. Efforts to Strengthen Protections
- 3. Enforcement and Compliance
- 4. Addressing Stigma and Improving Access
- 5. Looking ahead
- 6. How effective do you think the new rules finalized in September 2024 will be in addressing disparities in mental health coverage?
The U.S. Departments of Labor, Health and Human Services, and the Treasury recently unveiled their 2024 Report to Congress, shedding light on the enforcement and implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA). While the report acknowledges advancements in compliance, it underscores ongoing disparities in covering mental health and substance use disorder benefits compared to medical and surgical care.
Efforts to Strengthen Protections
Government agencies are ramping up efforts to enforce MHPAEA, ensuring that individuals face no greater hurdles when seeking mental health or addiction treatment than they would for physical health services. In September 2024, new rules were finalized to bolster these protections. These measures aim to clarify requirements for health plans and insurers, paving the way for improved access to essential benefits.
Acting Secretary of Labor Julie Su emphasized the strides made, stating, While health plans and insurance companies continue to fall short in providing parity in mental health and substance use disorder benefits, the Department of Labor’s efforts have achieved corrections that have directly benefited over 7.6 million participants in more than 72,000 plans.
She added, The departments’ recently issued final rules strengthen protections for participants, beneficiaries, and enrollees when trying to access mental health and substance use disorder benefits.
Health and human Services Secretary Xavier Becerra echoed this sentiment, asserting, Access to affordable mental health care and substance use disorder treatment is not only a vital component of our nation’s health – it’s the law.
He highlighted the alignment of these efforts with President Biden’s Unity Agenda and HHS’s broader behavioral health strategies.
Enforcement and Compliance
The Employee Benefits Security Governance (EBSA) and the Centers for Medicare & Medicaid Services (CMS) are intensifying their enforcement activities. EBSA oversees approximately 2.6 million health plans, while CMS focuses on individual and group markets in states lacking robust enforcement. Assistant Secretary for Employee Benefits Security Lisa M. Gomez noted,In enforcing the Mental Health Parity and Addiction Equity Act,the Employee Benefits Security Administration is exercising its full authority under the law to help ensure that workers,their families,and beneficiaries don’t face greater roadblocks in trying to access care for mental health conditions and substance use disorders.
Addressing Stigma and Improving Access
Beyond enforcement, the report highlights initiatives to combat the stigma surrounding mental health and addiction. It also includes an unredacted settlement agreement from 2024, illustrating corrective actions taken by a health plan to address MHPAEA violations. These examples serve as a roadmap for other plans to improve compliance and access to care.
Looking ahead
With the Consolidated Appropriations Act of 2021 granting new enforcement tools, agencies are better equipped to ensure parity between mental health and medical benefits.The annual reporting requirement keeps this issue at the forefront, fostering accountability and transparency. As enforcement efforts continue, the goal remains clear: to ensure equitable access to mental health and addiction treatment for all Americans.
For more details on MHPAEA enforcement, review the 2023 MHPAEA enforcement fact sheet, which highlights notable results from recent investigations.
How effective do you think the new rules finalized in September 2024 will be in addressing disparities in mental health coverage?
Interview with Dr. Emily Carter, Mental Health Policy Expert, on Progress and Challenges in Mental Health Parity
By Archyde News
Archyde: Thank you for joining us today, Dr. Carter.As a leading expert in mental health policy, you’ve been closely following the implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA). The U.S.Departments of Labor, Health and Human Services, and the Treasury recently released their 2024 Report to Congress. What are your key takeaways from this report?
dr. carter: Thank you for having me. The 2024 report highlights both progress and persistent challenges in achieving true mental health parity. On the positive side, we’ve seen significant advancements in compliance with MHPAEA, particularly with the introduction of new rules in September 2024. These rules aim to clarify requirements for health plans and insurers, making it easier for individuals to access mental health and substance use disorder (SUD) benefits. However, the report also underscores that disparities still exist. Many individuals continue to face greater hurdles when seeking mental health or addiction treatment compared to medical or surgical care.
Archyde: Can you elaborate on these disparities? What specific barriers are people encountering?
Dr. Carter: Certainly. One of the most glaring issues is the inconsistency in coverage. For example, some health plans impose stricter prior authorization requirements for mental health services than for physical health services. Others limit the number of therapy sessions or require higher copays for mental health visits.these practices create unnecessary obstacles for individuals seeking care. Additionally,there’s a shortage of mental health providers in many areas,which exacerbates access issues. Even when coverage is technically equal, the availability of care often isn’t.
Archyde: The new rules finalized in September 2024 aim to address some of these issues. How effective do you think these measures will be?
Dr. Carter: The new rules are a step in the right direction. they provide much-needed clarity on what constitutes parity, particularly in areas like network adequacy and treatment limitations. As a notable example, insurers are now required to demonstrate that their mental health networks are as robust as their medical networks. This could help reduce the provider shortage issue. However, enforcement will be key. Without strong oversight and accountability, these rules may not translate into meaningful change on the ground.
Archyde: What role do you see for government agencies in ensuring these rules are effectively implemented?
Dr. Carter: Government agencies play a critical role in both enforcement and education. The Departments of Labor, Health and Human Services, and the Treasury need to actively monitor compliance and take action against plans that violate parity requirements. Equally vital is educating consumers about their rights under MHPAEA. Many people aren’t aware that they’re entitled to equal coverage for mental health and SUD services.Empowering individuals to advocate for themselves is crucial.
Archyde: Looking ahead, what do you think needs to happen to achieve true mental health parity?
Dr. Carter: Achieving true parity will require a multi-faceted approach. First,we need continued advocacy and policy refinement to close existing loopholes. Second, we must address systemic issues like the shortage of mental health providers and the stigma surrounding mental health care. we need to invest in prevention and early intervention programs to reduce the long-term burden of mental health and SUD issues. It’s not just about equal coverage—it’s about creating a system that prioritizes mental health as much as physical health.
Archyde: Thank you, Dr. Carter, for your insights. It’s clear that while progress has been made,there’s still much work to be done. We appreciate your time and expertise.
dr. Carter: Thank you. It’s been a pleasure discussing this important issue.
End of Interview
This interview highlights the progress made in mental health parity while emphasizing the ongoing challenges and the need for continued advocacy and enforcement. Dr.Carter’s expertise provides valuable context for understanding the complexities of this critical issue.
