How federal mental health parity protections promote access to mental health services and integrated care

Insurance coverage for mental health services has long faced greater restrictions and limitations than coverage for general health. The passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 helped to address this gap by mandating that insurers offering coverage for mental health services do so in a manner that is equitable with medical/surgical coverage. This law built on the 1996 federal mental health parity law by extending parity to both quantitative (i.e., visit limits, co-pays, deductibles) and non-quantitative (i.e, medical management techniques, step-down therapy) treatment limitations. These protections originally applied to employee plans covering 51 or more employees. However, the passage of the Children's Health Insurance Program Reauthorization (CHIPRA) of 2009 and the Patient Protection and Affordable Care Act (commonly referred to as ACA) in 2010 extended these mental health parity protections to new types of plans. At the same time, the ACA also addressed a major loophole in MHPAEA, which did not require coverage of mental health or addiction services, by including mental health and addiction services in the definition of essential health benefits. These changes should result in significant improvements in access to mental health services. However, consumers will have a large role to play in helping to ensure plan compliance, and specific efforts and strategies to educate persons regarding their benefits and to catalogue problems with the implementation of these laws will be presented.