Nathaniel Weixel
TheHill.com
Originally posted 9 Sept 24
Health insurers will be required to cover mental health care and addiction services the same as any other condition under a highly anticipated final rule being released Monday by the Biden administration.
The move is part of the administration’s ongoing battle with health insurers, who officials say are skirting a 2008 law requiring plans that cover mental health and substance use care benefits do so at the same level as physical health care benefits.
The health insurance industry is likely to challenge the rule, saying the administration did not have the authority to issue it to begin with.
It argued the proposed requirements were unworkable and an unfunded government mandate that would cause employers to stop covering behavioral health services.
Essentially, any financial requirements and treatment limitations like copays, coinsurance and visit limits imposed on mental health and substance use disorder benefits can’t be more restrictive than the ones that apply to all medical and surgical benefits.
“Mental health and substance use disorder benefits should not come with any special roadblocks,” Lisa Gomez, the assistant secretary for employee benefits security at the Department of Labor, told reporters at a press conference.
Here are some thoughts:
The Biden administration has released a final rule requiring health insurers to cover mental health care and addiction services at the same level as physical health care benefits. This move aims to enforce the 2008 Mental Health Parity and Addiction Equity Act, which has been skirted by insurers. The rule mandates equal financial requirements and treatment limitations for mental health and substance use disorder benefits as for medical and surgical benefits. Health plans must conduct comparative analyses to ensure adequate access to care and comply with the rule to remain competitive. The administration believes this will expand mental health coverage, but the health insurance industry and some Republicans argue it's an overreach that will increase premiums and burden health plans. The rule is part of the administration's effort to address the worsening mental health and substance use crisis, with most people with disorders not receiving treatment due to prohibitive costs and limited access.
