For More Information:
Polly Ross Hughes
Mental Health America of Texas
512-454-3706, ext. 218
polly@mhatexas.org
For Immediate Release: Oct. 3, 2008
Passage of Mental Health Parity Legislation a Great Victory
Brain disorders are health conditions requiring proper medical treatment
AUSTIN — Mental Health America of Texas today hailed passage of federal mental health parity legislation that will broadly outlaw health insurance discrimination against Americans with mental health and substance-use conditions in employer-sponsored health plans.
Mental Health America of Texas and its national organization, Mental Health America, have worked for years to pass mental health parity legislation. Under parity, health plans must offer equal coverage for mental health conditions as they do other health conditions.
The legislation bans employers and insurers from imposing stricter limits on coverage for mental health and substance-use conditions than those set for other health problems. It will provide parity for 82 million Americans covered by self-insured plans and another 31 million in plans that are subject to state regulation.
It is estimated that roughly 67 percent of adults and 80 percent of children requiring mental health services do not receive help, often because of discriminatory insurance practices.
"Today Texas families and their loved ones needing mental health care celebrate a great victory for fair play. This legislation opens doors for those too long denied access to appropriate mental health treatment because of discriminatory practices," said Lynn Lasky Clark, president and chief executive officer of Mental Health America of Texas. "Disorders of the brain are just as treatable as heart disease, diabetes and other illnesses."
The legislation applies to group health plans of employers with 51 or more employees. The bill takes the following steps:
- In the case of a health plan that offers coverage for any mental health or substance-use condition, that coverage must be equal to medical coverage (except to the extent that a state parity law requires broader coverage). Specifically, it prohibits group health plans that offer coverage for any mental health or substance-use conditions from imposing treatment limitations and financial requirements on those benefits that are stricter than for medical and surgical benefits.
- If a plan offers out-of-network benefits for medical or surgical care, it must also offer out-of-network coverage for mental health and addiction treatment and provide an equal level of services.
- Strong state parity and consumer protection laws are preserved while extending parity protection to 82 million more people who are not protected by state laws and 31 million in plans that are subject to state regulation.
This federal legislation strengthens Texas state parity law for those now covered by it while extending equal benefits to other employer-based insurance plans that cover mental illness or substance abuse. For a map of state laws: www.mentalhealthamerica.net/go/parity/states.
Mental Health America of Texas, founded in 1935, is the oldest citizens’ mental health information, education and advocacy organization in the state. Its mission is to promote mental health, prevent mental disorders, and improve the care and treatment of people with mental illness. Its vision is to develop a society where mental health is the cornerstone of public health, stigma is eliminated and all Texans have access to comprehensive, high quality, culturally competent care.
What it Means for Texans
Texas is one of 38 states with some form of mental health parity law, ranging from limited to comprehensive. This state law regulates a smaller portion of health insurance plans in Texas.
The Texas parity law, expanded in 1997, covers the following mental health disorders: schizophrenia, schizoaffective disorder, bipolar disorder, obsessive compulsive disorder, major depressive disorder, autism, paranoia and psychosis and childhood depression.
For Texans, the federal law means:
- Plans subject to the state parity law can no longer set stricter or higher deductibles, co-pays, financial or service limits than those for other forms of health care.
- All other plans, if they offer mental health or substance abuse coverage, must offer equal benefits (including uniform copays, deductibles, financial or service limits) as the coverage offered for other forms of health care.
- The Children’s Health Insurance Program covered the same mental health benefits as the state parity law until budget cuts in 2003. While some mental health benefits were restored, CHIP is not covered by the state parity law. It would also not be covered by the federal parity law, which applies only to employer-based health insurance plans.