Mental Health Parity Finally Becomes Law

Article excerpt

On May 12, 1992 the first federal parity legislation was introduced. They say that "good things come to those who wait" and for millions of children and families across America, that "good thing" finally came on October 3, 2008 with the passage of the Paul Well- stone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Over the last 12 years advocacy groups from around the country, including NASP, worked to pass legislation that would require health insurers to provide mental health benefits on par with physical health benefits. Congressional and advocacy champions of this bipartisan bill included Senator Paul Wellstone (MN-D) who died in a plane crash in 2002; his children David and Mark Wellstone who, as cochairs of the Wellstone Action nonprofit group, took up their father's fight after his death; Senator Pete Domenici (NM-R), whose daughter has schizophrenia; U.S. Representative Patrick Kennedy (RI-D) and Rep. Jim Ramstad (MN-R), both of whom struggle with substance abuse dependency; Senator Ted Kennedy (MA-D); the Coalition for Fairness in Mental Illness Coverage; and the Mental Health Liaison Group, in which NASP is a member.

Mental health disorders are the second leading cause of disability and premature death in the United States. According to the U.S. Surgeon General, in the course of a year approximately 20% of children and adolescents in the U.S. experience signs and symptoms of a mental health problem and 5% experience "extreme functional impairment" (U.S. Department of Health and Human Services, 1999). Yet, every day, families with "good health coverage" discover that their loved ones cannot get the care they need because their employer-provided health insurance sets arbitrary, one-size-fitsall limits on mental health treatment but imposes no such limits on other medical or surgical benefits. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 sought to rectify this inequity by requiring parity for mental health benefits.

The Wellstone/Domenici Mental Health Parity Act applies to all Medicaid managed healthcare plans, State Children's Health Insurance Programs (SCHIP), and group health plans with more than 50 employees that provide mental health and substance abuse benefits. Under these applicable plans, the financial restrictions imposed for mental health benefits can be no more restrictive than those provided for physical health benefits. In simple terms that means that if the healthcare plan requires a $10 copay per visit, then the mental health care plan can not charge more than $10 per visit; and if the healthcare plan does not prescribe a set number of doctor visits for the resolution of an illness, then the plan can not prescribe a number for mental healthcare visits. …