MH Consumers Overcoming Discrimination via Federal Parity Act

Helping Families. Supporting Communities. Empowering Individuals.

Beginning on January 1, 2009, the Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (US Public Law 110-343) put physical and mental illness on equal terms when it comes to health insurance coverage. Traditionally, most employer and group health plans have set higher co-payments and deductibles while nonetheless providing less coverage for mental health care than for physical illnesses such as cancer, heart disease or broken bones. The new law will make it easier for 113 million Americans - 82 million people in employer-sponsored plans not protected by state parity laws - to obtain easier access and treatment for a wide range of mental health concerns such as Bipolar Disorder, Schizophrenia and co-occurring disorders such as alcohol and substance abuse. Said DMH Director Lorrie Jones about the change, "I'm thrilled. This represents far more than a mere technical revision in someone's health insurance policy, it's a long overdue expansion of civil rights that will lead to a new era in transforming our national health care system to one that focuses on the total wellness of health care consumers."

Changing the Face of Mental Health

PL 110-343 is expected to create more opportunities for greater mental health services access and more timely research in a number of ways:

  • Insurers will seek to fully integrate mental health coverage with medical and surgical benefits as they will no longer be allowed to devise separate cost-sharing requirements or treatment limits that apply only to mental illness and addiction disorders.
  • The eventual likelihood of seeing more financial resources (in terms of grants and private investment) directed to behavioral health resulting in a wider array of much-needed treatments and services.
  • An increase in persons seeking professional mental health assistance will provide a better understanding of the prevalence of mental health concerns in the general population in addition to more accurate data regarding treatment effectiveness.
  • Providers are very likely to continue to become more innovative in attracting consumers because of increased consumer treatment options.
  • Mental health consumers should be more likely to remain gainfully employed thereby contributing to local economies and reducing public expenditures for behavioral health.

Research suggests that improved access for mental healthcare may also result in increased insurance premiums. However the Congressional Budget Office estimates that PL 110-343 will increase premiums by an average of only about two-tenths of 1 percent. Moreover, businesses with 50 or fewer employees are exempt.

Under current Illinois law, parity exists for hospital or medical care coverage under accident and health insurance group policies and health care plans that provide for treatment of serious mental illnesses (SMI).