April 20, 2024

The Biden administration announces a new rule aimed at ensuring parity in mental health care coverage



CNN

President Joe Biden on Tuesday will announce a new act to guarantee access to mental health care, unveiling a proposed rule that would ensure mental health benefits on private insurance plans more closely match physical health benefits.

The proposed rule would strengthen the Mental Health Equity and Addiction Equity Act (MHPAEA) of 2008 by requiring insurance providers to update health plans “to ensure that people have equivalent access to their mental health and medical benefits,” according to an administration fact sheet shared with CNN ahead of Tuesday’s announcement.

“For the many families out there who are paying out of pocket to pay for the care their loved ones need, even when they have health insurance, help is on the way,” White House Domestic Policy Adviser Neera Tanden told reporters on a call Monday previewing the announcement. “This rule will ensure that we have true parity, and help ensure that we finally meet the mental health parity commitment required by law, to ensure that mental health is covered just like physical health.”

The rule would require insurers to evaluate coverage based on several benchmarks, including the plan’s network of providers, how much plans pay for out-of-network coverage and how often preauthorization and approval are required under existing plans, according to the administration.

“These analyzes will identify plans that fail to meet their requirements under the law, and will require plans to improve access to mental health care—by including more mental health professionals in their networks or reducing red tape to get care—to comply with the law,” the fact sheet says.

Enforcement of the rule will fall to the departments of Labor, Treasury and Health and Human Services, an administration official said.

“One of the big things this rule is doing is making it much easier to enforce when health plans are violating the rule’s standards,” the official told reporters before the announcement. “It’s very clear what health plans need to do to meet the mental health parity requirements so that regulators, whether it’s the Department of Labor, or state insurance commissioners, or whoever, can take those enforcement actions, and hold people to the standards of the rule.”

Tackling mental health — and the disparities between mental and physical health care — was part of Biden’s proposed “agenda of unity,” which he unveiled during his 2022 State of the Union address. At the time, he called on Congress to join him, saying: “And we get the mental health services that all Americans need. More people to go to for help, and full parity between physical and mental health care.”

The proposed rule would close a loophole that would have federally exempted health insurance plans from compliance with the MHPAEA, a move that the administration estimates would require more than 200 additional health plans to improve mental health care for 90,000 consumers.

Once the rule is published in the Federal Register, which officials expect to happen sometime next week, it enters a 60-day public comment period before it can take effect.

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