Spotlight:

Still on the Journey to Wellness Equality: The Mental Health Parity & Addiction Equity Act of 2008

Oct October 03 Wed 2018

It’s been a decade since the Mental Health Parity and Addiction Equity Act was signed into law, but it has a long way to go before its mandate guaranteeing equal health coverage for your brain as your body is fulfilled.  The MHPAEA, also known as the Federal Parity Act, was passed to make sure your health insurance covers care for conditions such as depression, PTSD or addiction the same way it does for illnesses like cancer, diabetes or heart disease. That means, with few policy exceptions, insurers may not charge separate or higher deductibles for mental health care, institute different reimbursement rates, charge more for treatment or limit the number of times a patient may see a mental health provider. 

While it held promise ten years ago as a considerable step forward in access to mental health care, two significant roadblocks have been keeping the spirit of the law from being fully realized.

The first is lack of awareness. According to a 2014 poll conducted by The American Psychological Association, only four percent of Americans said they knew about the Federal Parity Act.  An astonishing low number considering mental illness remains the leading cause of disability in the United States, according to the Substance Abuse and Mental Health Services Administration.   Adding to the urgency of the situation, a brand new report from the Lancet Commission tells us mental illnesses are increasing in every country on the globe and will cost the world’s economy some $16 TRILLION by the year 2030.   

Perhaps part of the awareness problem stems from when and how the Federal Parity Act became law; at the height of the worst economic crisis since the Great Depression.  First sponsored by then-Democratic Congressman Patrick Kennedy of Rhode Island and helped along in the Senate by his father, Ted Kennedy, it went through as just one provision in the massive bank bailout bill, TARP, Troubled Asset Relief Program, and garnered little attention of its own.  Add to that the absence of a robust national discourse or marketing push and, a decade down the road, the Mental Health Parity and Addiction Equity Act of 2008 remains unknown to most Americans.

Additionally, the law’s drive for health care equity often hits a dead end in statehouses across the nation where The Federal Parity Act is not even close to full legislative implementation.  As a ten-year check-up, a joint study conducted by the Kennedy-Satcher Center for Mental Health Equity, The Kennedy Forum, The Carter Center, Scattergood and Well Being Trust, graded each state on mental health parity.  Only one, Illinois, received an A.  Thirty-two states got failing grades, including California. The rest earned mostly mediocre C’s.  The full report card is at www.ParityTrack.org, along with assistance for appealing parity violations and a new consumer action campaign called Don’t Deny Me.

Other organizations offering help include The National Alliance for Mental Illness with a parity help page at www.nami.org and the American Psychological Association’s Help Center at www.apa.org.  Also, The American Psychiatric Association has crafted parity-implementation legislation for each of the 50 states as well as the District of Columbia which you can find at www.psychiatry.org.

To read more on the Lancet Commission’s Global Mental Health and Sustainable Development Report, referenced above, go to www.globalmentalhealthcommission.org.

The health and public policy experts advocating the Federal Parity Act feel that solving the awareness problem will go a long way in the push for full implementation.

As this landmark legislation enters its second decade, the Department of Psychiatry and Behavioral Sciences at Stanford agrees and encourages every medical insurance consumer to learn about their rights under the law and to contact their state representatives to demand the complete realization of the Mental Health Parity & Addiction Equity Act of 2008.  The result will be an empowered, healthier, more resilient and productive society in which barriers to the wellness of mind and body, including stigma and cost disparity, are finally left by the wayside.