The Biden administration wants to take action against health insurance plans that exclude those requiring drug addiction and mental illness treatment.
The Mental Health Parity and Addiction Equity Act is being enforced against health insurers via a proposed regulation released on July 25 by the Departments of Labor, Health and Human Services, Treasury.
The 2008-enacted law mandates that insurance providers must provide the same level of coverage for mental health care and drug misuse treatment as they do for other conditions.
"Mental health care is as important to the wellbeing of America's workers as medical care, and we must eliminate barriers to getting people the lifesaving care that they often need."- Acting Secretary of Labor Julie Su
Su says that the decision underlines the Biden-Harris administration's dedication to ensuring that all workers have equitable access to benefits for mental health and drug use disorders and enhancing employee wellbeing.
In America, the price of therapy varies on a variety of factors, including the therapist's education and expertise as well as the area in which it is provided. The typical cost in certain areas is significantly greater than in others. The cost of a single session typically ranges between $100 and $200, however, many providers may charge less, while others will demand more. Whether a client has health insurance affects the final cost as well.
Neera Tanden, a domestic policy counselor for the White House, told journalists over the phone on July 24 that too many insurers are skirting the rules and making it hard for people to obtain mental health treatment. Insurance companies frequently need more therapists, forcing patients to go outside their insurance network and pay extra.
Patients frequently need approval from their insurance company before receiving treatment, or their claims will be rejected, and they will be responsible for paying the expense. According to Tanden, this has resulted in millions of individuals with insurance having to pay out of pocket when they shouldn't. The National Institute of Mental Health estimates that 58 million adults in the United States, or more than one in five, live with a mental illness.
According to Tanden, the proposed regulation would force insurance companies to assess how their coverage guidelines affect patients' access to mental health and drug misuse treatment. She added that insurers must take action if they do not conform with the legislation. If patients seek therapy outside of the insurance network too frequently, this may include expanding the network of therapists, according to Tanden.
Before being completed, the proposed regulation would be subject to a 60-day public comment process. People with insurance had more difficulty receiving mental health treatments than other forms of medical care, according to a July survey of roughly 2,800 individuals.
According to a poll by the research center NORC, over 40% of persons with insurance via their workplace had to seek more expensive mental health care or drug misuse treatment outside of the network.
Comparatively, 15% of patients seeking physical health care utilized an out-of-network provider. Compared to 33% of patients who said the same for physical health care, more than 50% said their insurer had turned down coverage for mental health or substance misuse therapy three times or more.
Furthermore, approximately 60% of individuals polled who sought therapy for substance misuse or mental illness did not get any on at least one occasion.
- United States Department of Health and Human Services. Departments of Labor, Health and Human Services, Treasury announce proposed rules to strengthen Mental Health Parity and Addiction Equity Act.
- United States Department of Labor. Requirements Related to the Mental Health Parity and Addiction Equity Act: Proposed Rules.
- Psychology Today. Cost and Insurance Coverage.