Mental-health coverage expanded to most plans

Insurers will be required to cover mental illness to the same degree as physical ailments as the Obama administration moves forward with the largest U.S. expansion of behavioral health care in a generation.
Five years after the Mental Health Parity act was passed, and almost a year after the Sandy Hook shooting, regulations to fully implement the law were released Nov. 8. The new rules mean insurers won’t be able to charge higher co-payments or deductibles for mental illness or limit the duration of care.
Failures in treating mental illness have swelled the workload of police and pushed more emotionally disturbed people into emergency rooms, where they are less likely to get proper care. The new rules expand or protect behavioral health benefits for more than 60 million people, said Kathleen Sebelius, the U.S. health secretary.
“The parity law, which also applies to policies sold through the exchanges under the Affordable Care Act, is a milestone that recognizes how integral mental health is to overall health and ends discrimination,” said David Shern, interim president and CEO of Mental Health America, a lobbying group based in Alexandria, Va.
The Obama administration also considers the rules to be a chief component of an effort to reduce gun violence. The White House included improving mental-health services as one of 23 executive actions to combat gun violence after 26 children and adults were killed in a December shooting at Sandy Hook Elementary School in Newtown, Conn.
A common theme in many of the nation’s worst mass shootings is the gunman’s history of mental illness, including in Newtown, as well as massacres at the Washington Navy Yard this year; at an Aurora, Col., movie theater in 2012 and at the Virginia Tech campus in 2007.
The rules issued earlier will provide the most definitive regulatory standard to date for implementing the Mental Health Parity Act of 2008, which then-President George W. Bush signed into law. Bush left office in 2009 without his administration ever writing rules to implement the core part of that law. President Barack Obama’s administration issued interim rules in 2010 that still left many aspects of the law open to interpretation. Patrick Kennedy, the former Democratic congressman from Rhode Island who was a sponsor of the mental-health law, said the rules could be meaningless unless insurers are forced to obey them. •

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