Biden Administration Plans New Rule To Enhance Mental Health Coverage

The Biden administration is planning to implement a new rule that would put additional force behind a 2008 law -- the Mental Health Parity and Addiction Equity Act -- which requires health insurance providers offer customers access to the same level of mental health care as they do to physical health care.

"It's about making sure that there are more mental health care providers in your insurance plan's networks." said Christen Linke Young, Deputy Assistant to the President for Health and Veterans Affairs. "So that when you need mental health services, or your kid needs mental health services, you're able to find the services you need and get that care from an in-network doctor."

The new regulations would require that insurers to carry out an analysis of their health plans to determine whether beneficiaries have equal access to medical and mental health benefits and then take remedial action, if necessary.

That might mean adding more mental health care providers to the plan's network or removing paperwork barriers that inhibit access to care.

"The rule is focused on forcing health insurers to really measure the outcomes of their coverage, look at the networks they're providing, and to look at the way their paperwork barriers keep people from getting care," said Young in an interview Tuesday. "And if they are not at parity, if mental health care is harder to access than physical health care services under the terms of their plan, then insurance companies are going to have to make changes."

Under the parity law, there is an enforcement scheme in place. Depending on the type of health insurance, the insurer would be regulated by either the federal Department of Labor or by a state regulatory entity.

"That regulator can come in and ask to see those analyses. If they hear about gaps in access to care, or they've received complaints, or otherwise have a reason to believe that there are barriers to folks accessing care," said Young. "And then the regulator can require the health plan to take action."

Oklahoma Congresswoman Stephanie Bice is an advocate for improving mental health care for Oklahomans.

"We have a mental health crisis on our hands right now," Rep. Bice (R-OK5) said in an interview Tuesday.

Bice had yet to look over the details of the Biden administration's plan but agrees that something has to be done to improve access to care. She says she personally knows numerous people who have recently sought help from a mental health services provider -- "It is weeks or months before they can get in to see a therapist or counselor," she stated. "And if you’re in a crisis situation, that’s not acceptable."

Bice believes that part of the problem is a shortage of mental health professionals and says training more should be part of the solution.

"There needs to be entry-level and mid-level professionals that are there, willing and able, in a fast fashion, to be able to help those individuals that are seeking a treatment quickly," said Bice. "And we don’t have enough of them right now."

It's not clear how quickly the administration’s new rule could go into effect. A 60-day period of public comment begins this week.