Biden administration proposes new mental health care parity rule
Biden administration proposes new mental health care parity rule
In the U.S., mental health care is supposed to be covered by insurance companies, just like physical health care. But that’s often not the case. Today, the Biden administration is proposing a rule that will force insurers to stick to what the law requires.
Marketplace’s Kimberly Adams has spotlighted this issue on APM’s mental health podcast, “Call to Mind.” David Brancaccio spoke with Adams about what this rule could mean for insurance companies and mental health coverage overall. The following is an edited transcript of their conversation.
David Brancaccio: America’s mental health parity laws have been on the books for about 15 years or so. Why this new rule now?
Kimberly Adams: Because, according to the Biden administration, plus many advocates and lots and lots of patients, insurance companies often just ignore these laws or make it really hard for people to use them. So for example, maybe it’ll be easy to get your insurer to cover medication or nutrition counseling for something like diabetes, but not for an eating disorder.
Brancaccio: And what would the specific Biden administration proposal seek to change?
Adams: A couple of things. I was on a call last night with White House domestic policy adviser Neera Tanden, previewing this rule, and she said it would make insurance companies do their own evaluations to identify where they’re not adhering to the current law and give specific examples of what that looks like. And then fix those problems.
Neera Tanden: Specifically, health plans must use similar factors and setting out of network payment rates for mental health providers, as they do for medical providers. For example, they can’t use more restrictive prior authorization or narrow networks that make it harder for people to access mental health benefits than medical benefits.
Brancaccio: You’ve got a lot of people listening right now who want to know when they might start seeing some changes.
Adams: It’s a proposed rule. So it has to go through the normal comment and review process, which takes a few months. But hopefully, you’d see some change after that. One group that might see change a bit faster would be about 90,000 people covered under certain government provided insurance plans. There was previously a loophole that made about 200 of those plans exempt from the laws, and this rule would close that loophole.
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