Note: please note that this issue brief should (a) link back to the issue overview on this topic, (b) be focused either the local, state, national, or global level, and (c) be neutrally presented, based on facts, and include footnotes for each of the items.  See the Research Guide and Information Sources to assist you. 

• Link to issue overview on Mental Health Parity

Scope of the Problem  factual statements on the extent of the problem in the past, current, or future

• In the past, insurance coverage in the United States for mental health related issues remained second-tier to physical ailments. Often mental health conditions, if covered by insurance, faced higher copays and deductibles as well as different caps on doctor visits. “The trend away from parity started in the 1970s when insurers began to impose limits and cost sharing because mental health costs rose twice as fast as medical costs”. As growing pressure has mounted for reform new legislation, The Mental Health Parity and Addiction Equity Act of 2008, has been passed which may close the gap in insurance coverage. ^[1]
• Mental health has increasingly been seen as a treatable biological condition that should be covered by health insurance programs. Proponents of reform hope to create a healthier and more productive work force by providing equal resources for persons with mental illness. 

Past Policy  key legislation and milestones including significant policy and funding shifts, major studies, etc.

• Mental Health Parity Act (MHPA), 1996 

  • Required equality of mental health with medical/surgical benefits in terms of lifetime and annual dollar amounts under group health plans.

  • Provided discretion by employers on the scope of mental health benefits offered to employees and families.

  • Law does not apply to substance abuse or chemical dependency.^[2]

Current Policy  summary of current policies in the form of legislation, programs, and funding

• Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act of 2008

  • Federal law requiring equal coverage by providers for mental health benefits on par with other medical benefits. Does not require that insurers provide mental health coverage, but that the coverage must be equal if they do so.

  • Lower benefit limits, higher copays and deductibles, and caps on outpatient therapy days are a few of the practices that are now illegal under the new legislation.

  • "When the law is enacted, 113 million people across the country will have the right to non-discriminatory mental health coverage..." ^[3]

  • Legislation builds upon previous MHPA  of 1996, to expand coverage of all financial requirements

  • Enters into effect January 1, 2010. 

Key Organizations/Individuals   contacts for public and private organizations and key individuals

• Centers for Medicare and Medicaid Services

  • Provides information on mental health coverage for persons using medicare and medicaid.

    •      http://www.cms.hhs.gov/

• National Alliance on Mental Illness
  • Advocate enaction of mental health parity laws and offer greater resources and information.
    • By Mail: NAMI

      Colonial Place Three

      2107 Wilson Blvd., Suite 300

      Arlington, VA 22201-3042

    • By Phone: (703) 524-7600
    • Website: www.nami.org

• U.S. Government Accountability Office

  •      Creates reports evaluating effectiveness of legislation.

    • By mail: Government Accountability Office

      441 G St., NW

      Washington, DC 20548

      By phone: (202) 512-3000

      By email: contact@gao.gov

                             Website: http://gao.gov/index.html

Bibliography   web sites, reports, articles, and other reference material 

• GAO Report on Mental Health Parity Act (1996): http://www.gao.gov/archive/2000/he00095.pdf

• Helpful Tips and Explanation of the MHPA of 1996 by the Centers for Medicare and Medicaid Services: http://www.cms.hhs.gov/HealthInsReformforConsume/Downloads/MHPA_Helpful_Tips.pdf

• State Health Lawmaker's Digest on Mental Health Parity: http://www.ncsl.org/programs/health/forum/shld/12.htm

• Guide to State Parity Law, provided by NAMI: State Guide

• Chart to state laws on mental health parity as of 2007 and with additional resources: State Chart

• State Health Lawmaker's Digest on Mental Health Parity, resources on digging deeper. Numerous links to other organizations with reliable information on parity. http://www.ncsl.org/programs/health/forum/shld/12f.htm 

Footnotes

1. Cauchi, R., Thangasamy, A. December 18, 2008. "State Laws Mandating or Regulating Mental Health Laws." National Conference of State Legislatures. http://www.ncsl.org/programs/health/mentalben.htm (January 27, 2009). ▲
2. United States Department of Labor. Employee Benefits Security Administration. 2008. The Mental Health Parity Act. http://www.dol.gov/ebsa/newsroom/fsmhparity.html (January 29, 2009) ▲
3. "Summary of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act of 2008." Association of University Centers on Disabilities. www.aucd.org/docs/parityequityact2008.doc (January 30, 2009). ▲