Biden Administration Mandates Equal Coverage for Mental Health Services
The Biden administration introduces new rules requiring insurers to cover mental health care equally with other health services, ensuring access for millions of Americans.
Biden Administration to Mandate Mental Health Coverage Equal to Other Health Services
The Biden administration is finalizing a massive expansion of regulations that will require insurance companies to provide mental health and addiction treatment on the same terms as other health services. This move follows accusations that many insurers have not complied with the 2008 law on mental health coverage parity.
Government officials stated that insurers have ignored the law, and these new regulations are designed to tighten the rules, including potential fines for violators. However, this policy is expected to face legal challenges from the insurance industry. Neera Tanden, head of President Joe Biden’s Domestic Policy Council, said that the new rules would stop the avoidance practices of insurance companies, which have forced millions of people to pay for mental health care even when they are insured.
“No one should have to drain their savings or go into debt just to get mental health care,” said Tanden. “President Biden and the vice president believe that mental health is an essential part of overall health.”
This move is expected to impact millions of Americans, especially as the country faces a worsening mental health crisis. Many estimates suggest that the majority of people with substance use disorders and mental health conditions are not receiving adequate treatment.
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Some of the new rules will take effect next year, providing Vice President Kamala Harris with an important talking point on the campaign trail, as expanding access to mental health care is a widely popular issue.
Other parts of the regulations, which require more time, will take effect when insurance plans are renewed in 2026. Although the full regulations have not yet been released, senior administration officials indicated that the new rules are consistent with the proposals put forward by the White House last year.
The regulations reinforce that insurers cannot use tools such as prior authorization or out-of-network payment standards for mental health care that are stricter than for other types of services. Insurers will also be required to address material differences in access to mental health and substance use disorder treatment.
A 2022 report to Congress from the Departments of Health and Human Services, Labor, and Treasury found that none of the 156 insurance plans reviewed complied with the requirements to measure their adherence to the 2008 law.
The administration hopes to enforce the law through a collaborative approach but is ready to take firm action if necessary. However, this policy is likely to face pushback from insurers, who feel they are being unfairly targeted.
The insurance lobby group, AHIP, argues that workforce shortages are the primary reason for limited access to care. Some fear that the regulations could result in the acceptance of lower-quality providers, potentially endangering patient safety.
There is also concern that employers may reduce mental health coverage due to the increased costs associated with the expanded requirements. The regulations are expected to face legal challenges, especially after the Supreme Court overturned the Chevron doctrine, which allowed federal agencies to regulate based on reasonable interpretations of unclear statutes.
However, government officials remain confident that the new regulations align with applicable laws and will be successfully implemented.