ParityTrack tagged posts

Depression and Bipolar Support Alliance

“Worsening of symptoms,” “inability to work,” “hope for the best,” “stretch my medication” are a few of the reported consequences people face when they are unable to obtain an appointment with a psychiatrist. These responses and others like it come from a survey conducted by the Depression and Bipolar Support Alliance (DBSA) that revealed the challenges people face when their health insurance plans lack an adequate number of in-network psychiatrists. The short survey revealed that 38% of respondents were not able to make an appointment with an in-network psychiatrist and 40% believed the wait time between seeking an appointment with a psychiatrist and being seen was too long.

A mental health parity issue
DBSA and other mental health organizations have taken on this concern as a mental health parity issue. One of their goals is to advocate for solutions by identifying and defining the problem. Building on what was learned from the previous survey, DBSA is seeking more insight into the lengths individuals and families go to obtain care. To that end, we invite everyone to take our Access to Psychiatrist survey.

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Kelly O’Brien, The Kennedy Forum Illinois

When the historic Mental Health Parity and Addiction Equity Act of 2008 (“Federal Parity Law”) was enacted, Americans expected to have fewer barriers to access mental health and addiction services, and expected that behavioral health benefits would be provided on par with other medical/surgical health plan benefits. As Tim Clements of ParityTrack shared in a previous CFYM post, it is largely the state regulatory agencies that are responsible for implementing and enforcing the Federal Parity Law. Unfortunately, it’s now eight years since MHPAEA became law, and most states have not fulfilled that obligation, including Illinois. The result is that health plan beneficiaries continue to be denied access to behavioral health services and remain unaware of their right to access care as a part of their health plan’s covered benefits.

Authored by former Congressman Patrick J. Kennedy, founder of The Kennedy Forum, the law requires health insurance plans to guarantee that financial requirements and limitations on treatment benefits for mental health or substance use disorders are no more restrictive than the insurer’s requirements and restrictions for medical and surgical needs. The Affordable Care Act (sometimes known as Obamacare) expanded the Federal Parity Law to apply to even more health insurance plans.

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Tim Clement, Policy Director, ParityTrack

For most of the history of modern American health care, mental health treatment was not covered by insurance the same way other medical treatment was covered. Insurance plans often implemented arbitrary and restrictive annual and lifetime limits on inpatient days and outpatient visits. Copayments and coinsurance rates were often far higher than they were for other medical care. Separate and more expensive deductibles for mental health care were the norm.

Thankfully, the Mental Health Parity and Addiction Equity Act of 2008 (the Federal Parity Law) made this form of separate and unequal insurance coverage illegal. The Federal Parity Law prohibits insurance plans from imposing treatment limitations and financial requirements that are more restrictive for mental health and substance use disorder treatment than those used for the treatment of other medical conditions.

The good news is that health insurance coverage that discriminates against people with behavioral health conditions is now against the law. The bad news is that nearly a decade after President George W. Bush signed this landmark piece of legislation into law, insurance coverage for treatment of mental illness and addiction still is not on par with insurance coverage of other medical conditions.

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