Weak enforcement of existing laws has allowed insurance companies to continue illegal discrimination under the radar
Senate and House members are reintroducing legislation to prevent discrimination against patients seeking mental health and addiction care
WASHINGTON – U.S. Senators Amy Klobuchar (D-MN), Tina Smith (D-MN), and colleagues in the Senate and House reintroduced the Behavioral Health Coverage Transparency Act to increase oversight and enforcement to ensure that insurance companies cover behavioral health benefits and services in the same way they do physical illnesses. Weak enforcement of existing laws has allowed insurance companies to continue illegal discrimination under the radar, but this legislation would reinforce parity requirements under the Wellstone-Domenici Mental Health Parity and Equity Act (MHPAEA) by increasing the oversight and resources needed to stop behavioral health discrimination.
“All across our state and country, there are people suffering from behavioral health challenges and addiction, and it is critical we do everything we can to support them and their families on the path to recovery,” Klobuchar said. “This legislation would ensure that insurance companies are no longer able to discriminate when providing coverage to those seeking behavioral health coverage.”
“Our mental health system should be there for people at every age, from nursery to nursing home,” Smith said. “We have a responsibility here in Congress to enforce our landmark mental health parity laws. This legislation makes sure there aren’t holes in the net built to catch people when they’re struggling and need help.”
Their reintroduction comes in the aftermath of a federal judge's ruling in favor of over 50,000 patients who sued the nation's largest health insurer, UnitedHealth, for cutting costs at patients' expense and preventing them from getting recommended treatment unless their behavioral health issue was an emergency.
Mental health and substance use disorder coverage discrimination was banned in 2008, when Congress passed (MHPAEA) but weak enforcement has allowed insurance companies to get away with discrimination under the radar. A survey conducted by the National Alliance on Mental Illness found that nearly twice as many respondents had been denied coverage for mental health care as for general medical care. Another report found that patients sought mental health and substance use disorder treatment out-of-network almost three to six times more often than they sought physical care out-of-network.
Originally introduced in the Senate in 2016 and again in 2018, The Behavioral Health Coverage Transparency Act would:
- Require insurance issuers to disclose to federal regulators how they are making parity decisions, and the rate and reasons for denials of mental health claims;
- Require regulators to conduct no fewer than 12 random audits of health plans and to make public the results of those audits; and
- Establish a Consumer Parity Unit that gives consumers a single place to get information about their rights and to submit complaints with assurance of timely responses.
The legislation is led by U.S. Senator Elizabeth Warren (D-MA) in the Senate and Congressman Joe Kennedy (D-MA) in the House. It is also co-sponsored by U.S. Senators Edward J. Markey (D-MA.), Sherrod Brown (D-OH), Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Cory Booker (D-NJ), Bernie Sanders (I-VT), Debbie Stabenow (D-MI), Tim Kaine (D-VA), Kamala Harris (D-CA), Maggie Hassan (D-NH), Jeanne Shaheen (D-NH), Chris Van Hollen (D-MD), Kirsten Gillibrand (D-NY), and Chris Murphy (D-CT).
It has received support from the following advocacy and expert organizations:
A New PATH (Parents for Addiction Treatment and Healing), American Art Therapy Association, American Association for Geriatric Psychiatry, American Association of Child & Adolescent Psychiatry, American Counseling Association, American Group Psychotherapy Association, American Psychological Association, American Society of Addiction Medicine, Association for Behavioral Healthcare, Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD), Community Catalyst, Depression and Bipolar Support Alliance, Eating Disorders Coalition, Faces and Voices of Recovery, Facing Addiction with NCADD, Global Alliance for Behavioral Health and Social Justice, Jewish Federations of North America, Massachusetts Medical Society, Mental Health America, NAADAC, the Association for Addiction Professionals, National Alliance on Mental Illness, National Association for Children's Behavioral Health, National Board of Certified Counselors, National Council for Behavioral Health, National Eating Disorders Association, National Register of Health Service Psychologists, National Safety Council, NHMH - No Health without Mental Health, Residential Eating Disorders Consortium, School-Based Health Alliance, SMART Recovery, Student Coalition on Addiction, The American Osteopathic Academy of Addiction Medicine, The Kennedy Forum, Treatment Communities of America, and Young People in Recovery.