April 1, 2015

Report: Mental-Physical Health Care Parity “Still a Long Way to Go”

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Coverage for treatment between physical illnesses and mental ones still lacks parity, despite federal and state laws requiring it, according to a report issued today by the National Alliance on Mental Illness (NAMI).

According to the federal mental health parity law, passed in 2008 and expanded in scope under the 2010 Affordable Care Act, providers who offer such coverage are prohibited from putting coverage caps or higher copays on mental health treatment than on physical health treatment.

The law does not necessarily require insurance companies to provide mental health and substance abuse treatment coverage in their plans, and exemptions to the law also exist for small employer and individual plans. Still, many providers do offer mental health coverage.

Nevertheless, a large gap in such coverage remains. Among the report’s findings:

  • Serious problems exist in finding mental health providers within health insurance plans’ networks
  • There are high rates of denials of authorization for mental health and substance abuse care by insurers.
  • Many barriers exist in accessing psychiatric medications in health plans.
  • High out-of-pocket costs for prescription drugs appear to deter participation in both mental health and medical treatment.
  • High co-pays, deductibles and co-insurance rates impose barriers to mental health treatment.
  • Serious deficiencies exist in access to information necessary to enable consumers to make informed decisions about the health plans that are best for them in Affordable Care Act health care networks.

The report is based on a survey of 2,720 individuals and family members effected by mental illness or substance abuse issues, as well as a review of 84 health plans across 15 states.

Read the full report, “Mental Health Parity: Still a Long Way to Go.”