Mental Health Parity
Mental health parity is designed to end discrimination in coverage for mental health. It refers to protections on insurance coverage, which aim to ensure that limits on mental health benefits be no more restrictive than limits placed on medical/surgical benefits. These protections generally do not require that insurers offer mental health coverage. Instead, they require that all plans that do offer mental health coverage do so on an equal footing with general medical coverage.
Federal parity protections were first enacted in 1996, with the passage of a law prohibiting separate lifetime and annual limits on mental health benefits. Additional federal parity protections were passed in 2008, extending parity to substance abuse benefits and requiring equitable policies relating to both quantitative (e.g., co-pays, deductibles) and non-quantitative (e.g., medical management techniques) treatment limitations. The 2009 Children’s Health Insurance Program Reauthorization (CHIPRA) and the 2010 passage of the Affordable Care Act extended parity protections to new types of plans.
Implementing the New Federal Mental Health Parity Protections
Federal regulations that provide detailed rules about how the new, stronger mental health parity protections will apply were issued in February 2010. These regulations provide strong protections and prohibit insurers from imposing more restrictive copays, deductibles, visit limits, gatekeeper requirements and medical management techniques, as compared with those for general medical care.
Mental health parity protections are crucial to ensuring adequate access to mental health services, and the TeenScreen National Center is working with our partners to ensure effective implementation. Analysis of state-level mental health parity protections in New York found that many consumers and even health plan employees are unaware of the state benefit protections. See the full report here.
Monitoring implementation of the federal law will be equally important. For resources to help you understand and monitor how federal mental health parity protections apply in your own health plan, visit the Parity Implementation Coalition.
State Mental Health Parity Laws
The majority of states have passed their own mental health parity laws. Any state protections that are stronger than those passed at the federal level continue to take precedence. The federal laws, however, provide a minimum level of protection that must be met by all states.
The National Alliance on Mental Illness (NAMI) has prepared a guide summarizing parity laws in each state.