Biden proposes rules to promote mental health insurance coverage

The Biden administration released a fact sheet with new rules it is proposing to push insurance companies to expand their mental health coverage. The rules would require insurers to study whether their customers have equal access to medical and mental health benefits and to take remedial action, if necessary.

“Today, too many Americans still struggle to find and afford the care they need,” the White House said in its fact sheet on Tuesday, July 25. “Of the 21% of adults who had any mental illness in 2020, less than half received mental health care; fewer than one in ten with a substance use disorder received treatment. Research shows that people with private health coverage have a hard time finding a mental health provider in their health plan’s network.”

Biden administration officials promoted the proposed mental health insurance rules as a bolstering of the Mental Health Parity and Addiction Equity Act (MHPAEA).

Enacted in 2008, the MHPAEA requires that insurers provide the same level of coverage for both mental and physical health care. According to the White House, the law “was strengthened on a bipartisan basis in 2020.”

“Despite the repeated bipartisan efforts aimed at mental health parity, insurers too often make it difficult to access mental health treatment, causing millions of consumers to seek care out-of-network at significantly higher costs and pay out of pocket, or defer care altogether. One study shows that insured people are well more than twice as likely to be forced  to go out-of-network and pay higher fees for mental health care than for physical health care,” the White House said. “And the problem is getting worse: in recent years, the gap between usage of out-of-network care for mental health and substance use disorder benefits versus physical health benefits increased 85 percent.”

The proposed rules still need to go through a public comment period. In addition to announcing the rule, Biden also “announced the administration’s intention to issue a request for information on how it can best work with states to ensure compliance with MHPAEA’s critical protections for the millions of Medicaid beneficiaries enrolled in private Medicaid health plans,” according to the White House.