The Biden administration has unveiled new rules that will require insurers to expand mental health coverage and conduct in-depth examinations of patient outcomes.
A joint news release from the Labor, Health and Human Services (HHS), and Treasury departments on July 25 announced that the new rules were designed to strengthen the Mental Health Parity and Addiction Equity Act.
Broadly, this act requires private insurers to match the benefits of treating mental health and substance use disorders to those of medical and surgical treatments. This aims to prevent these companies from imposing additional restrictions for the treatment of mental health or substance issues through issuing copayments or requiring prior authorization.
Yet loopholes continue to exist.
For instance, these might result in insurers facilitating the receipt of nutritional counseling sessions for someone with diabetes while complicating access for another with an eating disorder, according to NBC 5 DFW.
Moreover, the independent research institute NORC at the University of Chicago found that insured individuals seeking mental health care were over 50% more likely to be forced to go out-of-network and pay higher fees than for physical health care.
Children seeking behavioral health care were 10 times more likely to be out-of-network than when seeking a primary care visit.
“HHS believes all Americans should have access to mental health and substance use disorder treatment, whenever and however they need it,” explained HHS Secretary Xavier Becerra in the news release.
“[We] continue to take actions to address the nation’s mental health crisis. We are ensuring that mental health is treated no differently than physical health and people in need of services have equitable access to care,” Becerra continued.
The new rules are still pending the inclusion of feedback from its public comment period, especially with regard to the collection of patient data and evaluation requirements.
Insurance companies would be compelled to review patient outcomes to ensure that benefits are being administered equally to those receiving different types of care. If not, they will have to take remedial action.
However, past measures to force insurers to comply with federal mental health pay parity requirements have been subject to pushback.
For instance, the ERISA Industry Committee, which represents large insurance providers, argued last year while lawmakers were considering the Mental Health Matters Act that sought to fine those who didn’t comply that it would “weaponize” the Department of Labor against employers, according to Fierce Healthcare.
The bill passed the House but did not pass the Senate due to Republican opposition, which echoed this sentiment.
In the wake of the lockdowns seen during the COVID-19 pandemic, public health officials have voiced concerns over the mental health of the nation’s younger generations.
For instance, U.S. Surgeon General Vivek Murthy issued an advisory on children’s mental health in December 2021, calling it an urgent public health crisis.
“Mental health challenges in children, adolescents, and young adults are real and widespread. … The future well-being of our country depends on how we support and invest in the next generation,” Murthy said.
Similarly, Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health, told The Associated Press that the findings of a survey conducted by the agency on high schoolers in 2021 were not only “devastating” but also “consistent.”
“There’s no question young people are telling us they are in crisis,” Ethier continued. “The data really call on us to act.”
Obesity — a public health problem that affects adults and youths alike — has been shown to exacerbate mental health issues.
As recently reported in The Dallas Express, recent studies have suggested that the effects of remote learning, isolation, and stress during the pandemic three years ago are still taking a toll on children and leading to a surge in student misbehavior.
Moreover, overdosing on fentanyl — a high-potency opioid that is 100 times stronger than morphine — has become the leading cause of death for Americans under age 50, according to the DEA.
The Texas government has launched a dashboard to track deaths caused by fentanyl across the state and raise awareness, as reported in The Dallas Express.