Senators keen to address mental health care this year are running into headwinds in an effort to ensure parity, the idea that health insurers cover behavioral health and addiction on the same level as physical health.
Why is this important: Advocates for decades have accused insurers of failing to adequately cover behavioral health services. The issue has become a priority for more lawmakers as the aftermath of the pandemic becomes evident.
Driving the news: The Senate Finance Committee announced five bipartisan mental health “focus areas” in February, including insurance coverage.
- The panel released discussion drafts on two of the less controversial areas, telehealth and youth mental health. But the application of “parity” in insurance coverage is met with resistance from groups of insurers and employers.
- A sticking point is the proposal for financial penalties against insurers who violate the parity requirements already enshrined in law. A Senate GOP aide said Republicans have “jurisdictional concerns” because the Senate HELP committee shares jurisdiction with finance.
- Parity “would probably be [be] the last to conclude” of the five areas, the aide said.
Between the lines: Under a 2008 law, insurers are supposed to provide equal coverage between physical and mental health. But several federal reports have concluded that this is not happening.
- The Department of Labor found this year that “health insurance issuers are failing to offer parity for mental health and substance use disorder benefits to those they cover.”
- “For example, one health insurance issuer covered nutrition counseling for medical conditions such as diabetes, but not for mental health issues such as anorexia nervosa, bulimia nervosa, and binge eating disorder. “, said the department.
Be smart: If insurers have to cover more mental health care, premiums and costs could rise. The prospect of passing this on to workers could be particularly difficult for companies in a tight labor market.
What they say : Asked about insurers’ lobbying for parity, Senate Finance Chairman Ron Wyden (D-Ore.) told Axios, “What’s up?”
“[Insurance companies] always say they do a phenomenal job,” Wyden said. “Everyone is fine, they do a great job and we should just appreciate them.”
- U.S. health insurance plans released their own parity roadmap last month and noted that the recent “surprise billing” law strengthened existing federal oversight.
- Employers have opposed some of the parity proposals that are in play.
- A group of employers wrote to lawmakers earlier this year that the real problem is “the shortage of mental health care providers and mental health care providers who don’t want to come into our networks.”
And after: Mental health legislation could be included in an omnibus spending deal slated for the end of the year, but it is unlikely to be ready in time to fit into a short-term funding bill that is due this month to keep government open.
- “I think everything is pushed to the omni[bus]Sen. Richard Burr (RN.C.), who leads the parity focus area for Republicans, told Axios about mental health efforts in general. arrive in the CR.”
The bottom line: Despite the resistance, Wyden says he continues to shine a light on parity, highlighting the early efforts of the late old Sens. Paul Wellstone (D-Minn.) and Pete Domenici (RN.M.).
- “A shadow network is what it sounds like: there are no providers, there is no one to direct you to a network, and if you get a claim, you might get a few bucks out of it,” Wyden said.
- Sen. Michael Bennet (D-Colo.), who chairs the parity field for Democrats, said in a statement that he was committed to finding a legislative path in Congress.
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