The Biden Administration has finalized a new regulation aimed at improving access to affordable mental health services for 175 million Americans with private health insurance. This move, announced on September 9, 2024, seeks to address longstanding issues in the implementation of the 2008 Mental Health Parity and Addiction Equity Act.
Despite existing legislation requiring equal coverage for mental health and other medical services, studies indicate significant gaps in access to care. As of 2020, less than half of U.S. adults with mental illness were able to receive treatment, while nearly 70% of children faced barriers to accessing mental health services.
The new regulation, set to take effect in 2026, mandates that health insurers evaluate their coverage of mental health providers, payment structures, and authorization practices. This approach aims to expand mental health provider networks and reduce out-of-pocket costs for patients.
White House Domestic Policy Advisor Neera Tanden highlighted the financial burden on patients, stating that those enrolled in private health plans paid an average of $1,500 per year in out-of-pocket costs for mental health care, double the amount paid by those without mental health conditions.
"It shouldn't be harder for you to find a provider that can treat your eating disorder than it is to find a provider who can treat your ulcer."
The U.S. Department of Labor, which regulates corporate-sponsored health plans under the Employee Retirement Income Security Act (ERISA) of 1974, will play a crucial role in implementing the new regulation.
However, the ERISA Industry Committee, representing U.S. employers sponsoring large health plans, has expressed concerns about potential cost increases for employer-sponsored health plans and enrollees.
This regulation is part of the Biden Administration's broader efforts to prioritize mental health care in its healthcare agenda. It addresses challenges in implementing mental health parity laws, which have been evolving in U.S. policy since the 1990s.
The new rule aims to tackle issues such as mental health provider shortages and the complex mix of public and private insurance in the U.S. healthcare system. By focusing on provider network expansion and reducing out-of-pocket costs, the administration hopes to make significant strides in improving mental health care access for millions of Americans.