The unfulfilled promise of mental health parity

Earlier this summer, the House of Representatives passed a bipartisan bill aimed at fixing this country’s broken mental health system. It contained some good proposals and was a welcome, if small, step forward. However, the bill failed to adequately address one enormous and essential component of meaningful mental health reform: parity. That is, the laws in this country requiring insurance companies to offer the same level of benefits for mental illness and substance use disorders that they do for physical health.

Despite the parity laws being on the books for years, patients suffering from mental illness and addiction still routinely struggle to get the benefits they deserve. A national study recently found that insurers deny mental health and substance use claims twice as often as they do medical and surgical benefits. At Health Law Advocates (HLA), this is a reality we encounter every single day. Our attorneys represent clients denied coverage for deadly behavioral health conditions, such as eating disorders and opioid addiction. We work with individuals and families facing barriers to needed treatment, mounting medical bills, and an inability to afford a lawyer to help them fight back.

{mosads}“Lee” is a recent client of ours suffering from substance use disorder. When outpatient treatment wasn’t enough, he sought more intensive care based on the advice of his doctor. Then his insurance company refused coverage. Knowing his life could depend on it, Lee entered treatment anyway, taking on the burden of thousands of dollars in medical bills. Luckily, he found HLA. We appealed the denial and won retroactive coverage. Today, Lee is not only on a path to health, he is free from the crippling debt and economic uncertainty that so often can impede sustained recovery.

Patients like Lee should not have to rely on lawyers to obtain coverage for the mental health or substance use disorder care that the laws of this country promise them. It’s past time for Congress to make good on that promise and put teeth behind our parity laws.

That’s the message I brought to Washington this month when I testified before the House Energy and Commerce Committee at a hearing dedicated to assessing the status of the mental health parity laws. My argument was simple: our federal parity laws aren’t protecting consumers the way they should. And until or unless we fix these laws, the United States’ mental health system will continue to fail patients in need.

Luckily, there are several simple, yet powerful, proposals on the table to remedy this. Rep. Joe Kennedy III (D-Mass.), an emerging leader in mental health policy, has authored legislation that would not only hold insurers accountable for failing to obey federal parity laws, but would provide patients with a clear avenue to formally lodge complaints when they are denied coverage. At last week’s hearing, Ranking Member Gene Green (D-Texas) committed to fighting for Kennedy’s bill in any future mental health conference. Sen. Elizabeth Warren (D-Mass.) has introduced companion legislation in the Senate. We are encouraged that the chairman of the Energy and Commerce Committee, Rep. Fred Upton (R-Mich.), and Rep. Tim Murphy (R-Pa.), one of the leading voices in Congress on mental health policy, have both shown a refreshing willingness to revisit parity, showing that there is bipartisan support for doing more to protect consumers.

This kind of support on both sides of the aisle has fueled past success at the federal level. Over the last two decades, the federal Mental Health Parity Act (MHPA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) have begun to remedy the inequities between coverage for behavioral health care and coverage for other medical services. In 2010, the Affordable Care Act further eliminated inequities in behavioral health care benefits by barring discriminatory coverage in many individual policies that had been exempt from the federal parity laws.

But HLA’s clients are living proof that dramatic gaps in coverage remain. Gaps which, if left unaltered, will be the Achilles’ heel of a mental health system that everyday American families cannot afford or access.

In the months to come, the House and Senate will continue working toward compromise on mental health policy reform. They, along with the entire mental health community, should reject any proposal that fails to make good on the promise of parity.

Matt Selig manages Health Law Advocates, a Massachusetts non-profit that represents disadvantaged people who have been denied insurance coverage for services.

The views expressed by authors are their own and not the views of The Hill.