The Affordable Care Act (ACA) was the first in this series of the parity laws to mandate behavioral health coverage, rather than require parity only if coverage is offered it added mental health and substance use disorders (SUDs) to its list of essential health benefits (EHBs) required in small-group and individual market insurance plans. 9 The law also has more sweeping protections that prohibit treatment and visit limits, cost sharing, and network limitations from being more stringent than those for medical and surgical benefits. Specifically, the MHPAEA extended the requirement that large-group health coverage for behavioral health services be no more restrictive than coverage for medical or surgical conditions to Medicare Advantage, Medicaid managed plans, and state Children’s Health Insurance Plans. In addition to reaffirming the MHPA requirements, the MHPAEA expanded these guidelines to apply to both substance use disorder and mental health services, while also instituting more comprehensive guidelines to promote behavioral health parity. Then, in 2008, Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA). 8ĭuring the next decade, several states implemented behavioral health parity policies with varying scopes in an attempt to close some of the remaining gaps of the MHPA. Additionally, the law’s requirements were limited: It allowed treatment limits, insufficient numbers of covered facilities, differences in cost sharing, and restrictive medical management techniques to remain. For example, health plans could receive a waiver if they demonstrated that their costs increased as little as 1 percent as a result of compliance. 7 While the MHPA was an important leap toward mental health parity, it contained many gaps by which insurers could evade compliance. In 1996, Congress passed the Mental Health Parity Act (MHPA), which prohibited large-group employer-sponsored health plans that provided mental health benefits from imposing more restrictive annual or lifetime limits on mental health benefits than those imposed on medical or surgical benefits. While there were regulations that mandated psychiatric coverage for federal employees in the 1960s and 1970s, behavioral health regulations were largely focused on mandated benefit laws, rather than parity, and these regulations were set by state legislatures. ![]() ![]() Prior to 1996, there were no national laws in the United States to govern behavioral health coverage in the private insurance market.
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