New Mental Health Parity Law Takes Effect But Questions Abound

In 2008, Congress passed sweeping legislation requiring that insurance companies provide enrollees suffering from mental illness with coverage equal to the coverage they would receive for any other type of condition. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 finally went into effect this year, and it promises to dramatically alter the way people with mental illness receive and pay for treatment. Even though the law is a large step forward for people with mental illness who frequently had to contend with higher co-payments and outright denials of treatment for their conditions, questions about the law's effectiveness remain.

Although the Act was supposed to go into effect on January 1, it took the Departments of Health and Human Services, Labor and the Treasury until January 29th to issue new rules for mental health parity and the rules went into effect on April 5. According to the Department of Health and Human Services, "The new rules prohibit group health insurance planstypically offered by employersfrom restricting access to care by limiting benefits and requiring higher patient costs than those that apply to general medical or surgical benefits." What the press release does not point out, however, is that the rules apply only to group health plans covering more than 50 employees, and that plans that see an increase in costs of more than 2 percent due to the new parity rules can opt out in the following year. (The new health care reform law will eventually make mental health parity applicable to all insurance plans).

A helpful article in Kaiser Health News points out some of the pluses and minuses of the new law. Denise Camp, a 50-year-old woman who runs a center for recovering psychiatric patients is one of the beneficiaries of the new law. According to the article, Ms. Camp used to pay $50 to visit a social worker and $75 for a psychiatrist. Now, due to the new regulations, Ms. Camp will have to cover only a $10 co-payment for visits to any of her doctors. On the other hand, the article reports that several companies around the country have already dropped coverage and switched to plans that offer no coverage for mental illness at all.

To read and comment on the new regulations, which are not an easy read, click here and then choose any of the three "interim rules" listed.

To read the Center for Medicare Advocacy's summary of the new regulations, click here.