Report: Mental Health Parity at a Crossroads as 1-4 Have Unmet Behavioral Health Needs
“More than 25 years after the first federal mental health parity protections were put in place, adequate coverage for behavioral health care – including both mental health and substance use conditions –remains elusive for many consumers with health insurance.”
That’s the conclusion of a recent report from the Kaiser Family Foundation (KFF) entitled “Mental Health Parity at a Crossroads.”
More than 1 in 4 Adults Have Unmet Behavioral Health Care Needs
Since COVID, several issues have developed that contribute to the access and coverage challenges in health insurance that behavioral health parity was supposed to help address, including:
- Rising behavioral health treatment needs.
- Worsening Behavioral Health workforce shortages.
- The need for improved coordination and integration of primary care and behavioral health care.
As a result, 32% of adults in the United States reported symptoms of anxiety and/or depressive disorder as of February 2022. Among these adults, 27% reported having unmet mental health care needs.
Among those not receiving treatment, 23% indicated that they skipped or delayed therapy due to cost, while 25% cited not knowing where to obtain care as a reason they did not access services.
Complex Mental Health Parity Standards and Poor Compliance
According to the Report, “Federal protections for behavioral health coverage sought to correct historical differences in how health insurance covered this care when compared to medical/surgical benefits.”
However, several pieces of legislation passed over the years and a host of rules developed by multiple government agencies have resulted in “detailed and complex standards making it a challenge for consumers with coverage to know what practices violate the law.” Furthermore, the report cites several analyses that indicate parity compliance is inadequate for both private insurers and Medicaid.
Mental Health Parity Improvement Initiatives: Simplified Standards, Enhanced Enforcement
KFF notes several avenues that legislators and regulators are pursuing to help address the shortcomings in the Mental Health Parity initiative, including:
- Simplifying standards, such as development of external benchmarks that are at a minimum based on nationally recognized standards of care.
- Assessing network adequacy and access to care, including the impact of telehealth.
- Giving enforcement agencies more mechanisms to hold plans accountable, including requiring plans to report data related to parity.
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