Mental health parity law implementation evolves

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for Kaiser Health News and The Washington Post, Sandra Boodman considers the effect that the American mental health parity law has had since it went into effect on Jan. 1.

The law applies to about 140 million Americans, Boodman writes, most of whom are insured by employers with more than 50 employees. For qualifying groups, “Higher deductibles, steeper co-pays and other restrictions are no longer allowed for mental health and substance abuse treatment.” It doesn’t apply to individual policies and doesn’t require employers to offer mental health coverage of any kind.

There are still questions about the implementation of the law, many of which are addressed in the Obama administration’s implementation plan (PDF), which should take effect on July 1.

Officials of key business and insurance industry groups said they were displeased that the regulations were “more expansive” than they believe lawmakers intended. Mental health advocates applauded the rules, which they said would help ensure that Americans battling schizophrenia, for example, receive the same level of care provided to those facing leukemia.

Federal officials estimate that complying with the law will increase premiums nationwide by four-tenths of 1 percent, or about $25.6 billion over 10 years. Employers are free to drop mental health and substance abuse coverage and are allowed to manage claims to determine if treatment is medically necessary, just as they do now for physical ailments, but the standards can no longer be more stringent. Plans are also allowed to exclude treatment for certain illnesses, such as eating disorders, as long as state law does not mandate coverage. There is also an escape hatch: Plans that can prove that their costs increased by more than 2 percent in the first year can file for an exemption.

Fortunately, it looks like that sort of cost increase will be rare, based on research that shows similar rules improved access without increasing cost.

For some background on the mental health parity law, check out MIWatch.org.

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