Mental health and addiction can no longer be subject to special fees, co-pays, deductibles and utilization limits not applied to medical and surgical services, the White House announced Friday.
The long-expected changes to mental health coverage were finalized this week, the Obama Administration said. Based on the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA), the rules prevent employers with more than 50 full-time workers from offering plans less favorable towards mental health.
“For way too long, the healthcare system has openly discriminated against Americans with behavioral health problems,” said Health and Human Services Secretary Kathleen Sebelius. “In the past, it was legal for health insurance plans to treat these disorders differently from medical and surgical needs.”
The law does not apply to policies offered under Medicare or Medicaid. However, the Obama Administration has previously issued guidance to state health officials signaling that plans should meet parity requirements of the MHPAEA.
The White House estimated that before the MHPAEA was enacted, 60% of Americans with mental health conditions, and 9 in 10 individuals with addictive disorders didn’t receive proper coverage from their employers.
Now, employers will be required to choose plans with co-payments, limits on visits to providers, and deductibles for mental health benefits to match those offered for standard care. Employers will also need to offer the same residential treatment and outpatient services for mental health care.
Some businesses and health insurance carriers have raised concerns about the expense of treating mental health and addiction issues without the aid of additional fees and co-pays, though experts believe the new rules won’t meaningfully add to coverage costs as so few patients require these levels of care.