Biden pledges ‘mental health care is health care’ with new rule ensuring mental health parity in insurance coverage

CNN
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President Joe Biden on Tuesday announced new action to guarantee access to mental health care, unveiling a proposed rule that would ensure mental health benefits on private insurance plans more closely mirror physical health benefits.

The proposed rule would reinforce 2008’s Mental Health Parity and Addiction Equity Act (MHPAEA) by requiring insurance providers to update health plans “to make sure people have equivalent access between their mental health and medical benefits,” according to an administration fact sheet shared with CNN ahead of Tuesday’s announcement.

During an event at the White House, Biden said the moves “represent a real step forward to help millions of people get mental health care they need and that insurance should be providing.”

“Folks, you know, I don’t know what the difference is between breaking your arm and having a mental breakdown is – it’s health, there’s no distinction. It’s health,” Biden said. “You know, we can all agree, mental health care is health care. It is health care, it’s essential to people’s well-being and their ability to lead a full and productive life, to find joy, to find purpose, to take care of themselves and their loved ones. It’s about dignity.”

The rule would call on insurers to evaluate coverage based on a number of benchmarks, including the plan’s provider network, how much plans pay for out-of-network coverage and how often prior authorization is required and approved under existing plans, according to the administration.

“These analyses will show plans where they are failing to meet their requirements under the law, and will require plans to improve access to mental health care – by including more mental health professionals in their networks or reducing red tape to get care – to be in compliance with the law,” the fact sheet states.

Enforcement of the rule will fall to the departments of Labor, Treasury and Health and Human Services, an administration official said.

“One of the major things this rule is doing is making it much easier to enforce when health plans are violating the standards of the rule,” the official told reporters ahead of the announcement. “It is making extremely clear what health plans need to do to be in compliance with the requirements of mental health parity so that regulators, whether the Department of Labor, or state insurance commissioners, or whomever, have the ability to take those enforcement actions, and really hold people to the standards of the rule.”

Addressing mental health – and the disparities between mental and physical health care – were part of Biden’s proposed “unity agenda,” which he unveiled during his 2022 State of the Union address. At the time, he called on Congress to join him, saying: “And let’s get all Americans the mental health services they need. More people they can turn to for help, and full parity between physical and mental health care.”

On Tuesday, Biden lamented the state of mental health coverage in the United States, noting that “for millions of Americans, mental health care and treatment for substance abuse is out of reach,” while observing that, in 2020, less than half of adults diagnosed with mental illness received care.

“For children, the number is even worse: Nearly 70% of our kids who seek care for mental health or addiction cannot get it – 70%,” he said. “Talk to parents and teachers, talk to the school nurses and counselors, talk to young people, they’ll tell you there’s a serious youth mental health crisis happening right now in this country. We must fulfill the promise of true mental health parity for all Americans.”

He added, “We have a moral obligation, in my view, to be there for each other, to reach out, reach to our neighbors with grief and stress and trauma and despair, reach out to them to offer help, or just a listening ear, to have the courage to ask for help when we need it, and it’s hard, because we know that even when it feels as dark as you can get, we aren’t alone. It’s important for people to realize they’re not alone. That’s what I want, I want everyone in America not to feel isolated or alone, to know their country has their back, to know their president has their back.”

The proposed rule would close a loophole that exempted federally provided health insurance plans from complying with the MHPAEA, a move that the administration estimates would require more than 200 additional health plans to improve mental health care for 90,000 consumers.

Once the rule is published in the Federal Register, which officials expect will occur sometime next week, it enters a 60-day public comment period before it can take effect.

This story has been updated with additional information.