With the staggering rise of mental health and substance use conditions across the nation, policy makers are moving toward more progressive approaches to this crisis through expanded funding of innovative programs and services, and through the protection of health plan coverage for mental health and substance use treatment. In the Statement of Administration Policy for House Bill 7780-Mental Health Matters Act of 2022, the White House recognized the urgency and need to “prioritize mental health as a critical aspect of well-being” in our nation.
Momentum has been increasing around this topic, and 2023 might be the year legislation passes to afford help where it is needed most. In his 2023 State of the Union address, President Joe Biden outlined several areas where mental health could be supported. However, legislators and activists have been working to effect change in mental health and substance use areas for quite some time.
Background
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 secured greater access to mental health and substance use health plan coverage for millions of Americans.
Building from the Mental Health Parity Act of 1996 which limited health plans from enacting fund limits to mental health benefits, the MHPAEA ensures that mental health and substance use health plan coverage aligns with medical/surgical coverage.
While MHPAEA does not require health plans to cover mental health and/or substance use treatment, it does specifically eliminate disparate annual and lifetime financial (such as deductibles and co-pays) and treatment limits (such as number of visits) for health plans that provide mental health and/or substance use benefit coverage.
Setting the Stage for Change
In September of 2022, legislators passed the Mental Health Matters Act designed to hold health plans to higher accountability for denials of mental health and substance use treatment coverage. This act gives the Department of Labor authority to enforce equitable coverage of mental health and substance use treatment as outlined in the MHPAEA of 2008. Additionally, the Mental Health Matters Act provides funding to expand school-based mental health services in recognition of the need for access to preventative treatment and earlier intervention.
Watch for more legislation around mental and behavioral health, and contact Renaye James Healthcare Advisors with questions or comments about how best to implement change to ensure the best possible outcomes.
Pamela Llewellyn, MSW, LCSW-C, MBA, is a senior advisor of behavioral health services at Renaye James Healthcare Advisors and the founder of Grow by Grace LLC.