New mental health equality laws are at stake

The ink was almost dry on new federal legislation for the implementation of the Mental Health Parity and Addiction Equity Act of 2008 when US health plans threatened possible legal action to block it.

Buoyed by a recent Supreme Court decision that takes away power from government agencies, health plans appear to be hoping to block the Departments of Labor, Treasury, Health and Human Services. Democracy creates equality, years after Congress passed the law with strong partisan support.

When creating the new rules, the agencies took careful consideration to consider all factors during a 13-month comment period, listening to patients, families, health care providers, employers, mental health advocates and the insurance companies themselves. More than 95% of all participants expressed support for the regulations. However, these organizations took the opposition’s views seriously, withdrawing the proposal that the insurance companies strongly opposed.

Now the insurers are back, threatening action in the courts – and passing on a golden opportunity to heal their discriminatory practices after years of delay and denial.

As written, the regulations directly support the law’s intent by requiring health plans to compare how they cover mental and physical health, to look for “material differences” and to take “reasonable action” to resolve them. Any health plan that provides “purposeful benefits” for physical health will be required to do the same for mental health.

Since health plans have until January 1, 2026, before key parts of the rules go into effect, there is still plenty of time for them to come into compliance (considering what they already have). given from time to time).

Threats of legal action, therefore, do not reflect disputes over the rulemaking process or objections to expedited enforcement. Insurers show denial of mental health coverage.

This helps explain the 16 long years of non-compliance with the Parity Act, where health plans paid lip service to mental health while depriving millions of people of essential care. , often life-saving. It also explains why health plans have squeezed mental health and substance abuse providers with low fees and endless administrative games that have forced thousands out of treatment. insurance.

The stubborn resistance to mental health proves that health plans are not in our corner, despite the empty promises we hear every fall during registration. What is even more difficult to understand is that, by refusing to fit, insurers are blocking billions in cost savings that would clearly serve their financial interests.

When researchers at the consulting firm Milliman conducted an independent analysis of data collected from insurers themselves, they found that people with mental health or substance abuse conditions were -have 2.8 to 6.2 times more physical health care costs, yet half receive almost no treatment. these conditions.

Treating mental and physical health in moderation can save commercial insurers between $19 billion and $38 billion each year, Milliman found. But, by separating mental health and physical health into hermetic corporate silos, health initiatives seem intent on chasing short-term gains on the side of mental health. by delaying and denying valid, well-documented claims – often paying back payments months or years after services arrive. transferred.

Meanwhile, their beneficiaries get sicker without the care they need or kill themselves trying to pay for it.

In light of these challenges — and evidence that our underpaid mental health workers may be at their peak — the state’s new laws are an important step in a decades-long battle to try – enough. The new rules will make it easier for people to find mental health providers in their network and reduce the number of denials of care they receive from their insurers. That means patients have less time fighting over the phone and filing paperwork and more time to spend on actual treatment and recovery.

If insurers file suit to block them, they will prove that they are more committed to the dysfunctional state than the progress demanded by lawmakers on both sides of the aisle, in 2008 and now. But there is still room for a very different outcome.

Insurers have the power to heal the discriminatory practices that have harmed millions. Accepting – or simply accepting – the rules will connect them to the natural truth that mental and physical health are inseparable. This is why parity saves money and serves the interests of all stakeholders, including insurers.

David Lloyd is chief strategy officer of Undivideda non-profit organization dedicated to achieving the success of federal and state policies that advance the mental health of all Americans.