Giving Benefits the Respect They Deserve (and the Law Requires)

If you offer your employees health benefit coverage, your substance abuse and mental health benefits should be comparable to the other medical benefits in your plan.

The Mental Health Parity and Addiction Equity Act (Parity Act) of 2008 is a federal law that requires group health plans and health insurance issuers to offer plans that don’t impose more limitations on mental health and substance abuse disorder benefits than on medical and surgical coverage. For instance, a plan cannot put more restrictive visit limits or impose higher cost sharing on mental health treatment than they would on treatment of a physical ailment.

The World Health Organization reports that one in four people in the world will be affected by mental or neurological disorders at some point during their lives. Around 450 million people currently suffer from these conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.

Drug abuse also is a growing problem. The National Survey on Drug Use and Health estimated that 19.7 million American adults (age 12 and older) battled a substance use disorder in 2017. About 38 percent of adults in 2017 battled an illicit drug use disorder.

The Parity Act has been law for more than a decade, but has not been fully implemented or enforced. The Partnership for Drug-Free Kids reports widespread non-compliance with the requirement to cover addiction treatment. The report also asserts that lack of access to effective and affordable treatment contributes to nearly 200 lives lost daily because of overdose.

A bill introduced in 2019 in both houses of Congress would require health plans and insurers to conduct in-depth analyses to ensure that plans are compliant. In addition, the secretaries of both the Department of Health and Human Services and Labor would be allowed to request these analyses if they receive patient complaints that plans are not compliant.