Mental health parity legislation a civil rights victory, but price concerns remain

by Elena Skoura, Graduate Intern, bWell-informed

Congress passed a great victory for civil rights on October 3, 2008—the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act. Named after the deceased Democratic Minnesota senator and the retiring New Mexico Republican senator, the law (HR 1424) requires group health plans of 51 or more employees to cover mental illnesses to the same extent as physical diseases. It is considered a fundamental step towards eliminating the stigma and prejudice the 113 million Americans suffering from mental illness have faced.

The new legislation, which goes into effect for most health plans on January 1, 2010, will extend mental health services to 82 million Americans who live in states that have not already passed mental health parity legislation.

This legislation requires health insurance companies to charge the same deductibles, copayments and out-of-pocket expenses for mental health treatments that they do for physical conditions. Plans are not obliged to offer mental health coverage or cover every mental health condition—but for what they do cover, the costs must be equivalent.

To address concerns that small businesses would find it hard to afford mental health coverage for their employees and might choose to eliminate it altogether, the legislation applies only to group health plans with more than 50 workers. However, small businesses may still be required to offer mental health parity if required by the laws of the state in which they operate.

While MHPA also doesn’t apply to insurance coverage in the individual/non-employment based market, the victory may ultimately impact consumers in the individual market as well. Legislative changes in group health plans often "trickle down" to other types of coverage. If the legislative changes were to apply to individual coverage, consumers could see prices rise considerably to cover the new levels of coverage. To keep plans affordable, some insurers might opt not to offer any mental health coverage at all.

While price remains a concern, the new legislation encourages hope that in the future, human welfare will be approached in a open-minded way. Mental illness should be acknowledged and treated with respect and concern, following the ancient Greek saying: “You shall have a healthy mind in a healthy body”—and vice versa.