What the next push on mental health parity might look like

Some senators, advocates want to plug gaps in the nation’s mental health parity laws

On Capitol Hill, there’s been an intense interest over the last year in addressing the nation’s mental health crisis. 

Here’s one problem area both lawmakers and advocates have identified: Unequal coverage between mental health and physical health. 

Earlier this week, Sens. Michael Bennet (D-Colo.) and Ron Wyden (D-Ore.) introduced legislation aimed at beefing up what’s called mental health parity, the requirement that insurers providing behavioral health benefits do so on par with medical and surgical care. Even Bennet acknowledges the bill as a whole, which he said is expected to cost billions, is unlikely to pass any time soon.

“I think this is going to be a long haul,” he said in an interview. “This is an aspirational piece of legislation to try to put a marker down.”

Even though the bill faces an uphill battle, the legislation underscores the significant gaps in existing mental health parity laws, which don’t apply to some major public health insurance programs. Bolstering the nation’s mental health system has broad bipartisan support, with the pandemic’s immense emotional toll exposing the barriers to quickly and easily getting care. But the devil is in the details, with Republicans expected to be wary of any legislation costing a significant amount of money. 

In 2008, Congress passed a law requiring mental health parity for group- and self-insured health plans covering more than 50 workers. But the rules don’t apply to Medicare, and the mandate only exists for parts of Medicaid, such as managed care plans. 

“There have been these long-standing gaps in the federal parity act that have meant that tens of millions of Americans don’t benefit from its protections,” said David Lloyd, the chief policy officer for the Kennedy Forum, which is devoted to implementing parity laws. “These gaps really aren’t justifiable.”

Enter the Bennet-Wyden legislation. The bill would require parity for mental and behavioral health services in Medicare Advantage, Medicare’s voluntary prescription drug program and the broader Medicaid program. Among other measures, it includes efforts to incentivize integrating mental and physical care, such as increasing reimbursement rates for Medicare and Medicaid. 

Some advocates have been itching for that for years — and want to go further. 

Craig Obey, the chief of government relations for the American Psychiatric Association, said the group developed legislation last year to apply parity to all parts of the Medicare program and shared it with the Senate Finance Committee, which Bennet sits on and Wyden…