Enforcing Mental Health Parity Through the Affordable Care Act's Essential Health Benefit Mandate

39 Pages Posted: 27 Sep 2014

See all articles by Kathleen G. Noonan

Kathleen G. Noonan

University of Pennsylvania - Children's Hospital of Philadelphia; University of Pennsylvania - Perelman School of Medicine

Stephen Boraske

Temple University - James E. Beasley School of Law

Date Written: September 25, 2014

Abstract

This paper identifies a critical failure in U.S. mental-health insurance regulation, and proposes a solution. The 2008 federal Mental Health Parity law required “parity” in coverage for mental health benefits. But, it permitted insurers to opt out of providing any mental health insurance benefits at all — which many did. The Affordable Care Act (Obamacare), in contrast, requires mental health coverage for all plans sold through Exchanges. Yet, the federal government has continued to defer authority to states and insurers to define what that coverage should be resulting in sub-par mental health coverage. We reviewed the “benchmark” standards put in place by all 50 states in response to the ACA and found broad variability in mental health inclusions, exclusions and limitations. Currently, these laws are siloed. We argue that the laws, if enforced together, would assure true parity in mental health care coverage and offer concrete steps for regulators can take to do this. As a first step, we propose that the federal government use its regulatory authority to identify a minimum standard for mental health benefits to address the variability found in our review of state standards. Timing for this solution is urgent as federal regulators have a narrow window in the next year and a half to adjust Obamacare plans to provide a more robust mental health benefit upon which more standardized federal and state enforcement could take place.

Keywords: mental health, parity, affordable care, essential health benefit

Suggested Citation

Noonan, Kathleen G. and Boraske, Stephen, Enforcing Mental Health Parity Through the Affordable Care Act's Essential Health Benefit Mandate (September 25, 2014). Annals of Health Law, Forthcoming, Available at SSRN: https://ssrn.com/abstract=2501694 or http://dx.doi.org/10.2139/ssrn.2501694

Kathleen G. Noonan (Contact Author)

University of Pennsylvania - Children's Hospital of Philadelphia ( email )

34th Street and Civic Center Boulevard
Philadelphia, PA 19104-4399
United States

University of Pennsylvania - Perelman School of Medicine ( email )

423 Guardian Drive
Philadelphia, PA 19104
United States

Stephen Boraske

Temple University - James E. Beasley School of Law

1719 N. Broad Street
Philadelphia, PA 19122
United States

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