New rule demands parity for mental health coverage

Advocates say it will end discrimination of those with behavioral or drug abuse issues
Associated Press
Nov 8, 2013


It's final: Health insurance companies now must cover mental illness and substance abuse just as they cover physical diseases.

The Obama administration issued new regulations Friday that spell out how a 5-year-old mental health parity law will be administered.

Health and Human Services Secretary Kathleen Sebelius said the rule should put an end to discrimination faced by some mental health patients through higher out-of-pocket costs or stricter limits on hospital stays or visits to the doctor.

The law, signed by President George W. Bush, was designed to prevent that. But mental health advocates said health insurers at times sidestepped lawmakers' intentions by delaying requests for care and putting in place other bureaucratic hurdles. They described the new Obama administration rule as necessary to ensure patients get benefits they are entitled to receive.

The administration had pledged to issue a final mental health parity rule as part of an effort to reduce gun violence. Officials said they have now completed or made significant progress on 23 executive actions that were part of a plan announced in response to the school massacre in Newtown, Conn., last December.

The 2008 mental health parity law affects large group plans. The Affordable Care Act requires individual and small group plans to treat mental health and substance abuse coverage the same way physical illness coverage is treated.

"For way too long, the health care system has openly discriminated against Americans with behavioral health problems," Sebelius said in a telephone conference call with reporters. "We are finally closing these gaps in coverage."

Sebelius said that access to mental health coverage had already been improving since passage of the mental health parity law. She noted that larger employer health insurance plans already have eliminated higher cost-sharing for inpatient mental health care and said most plans have done the same for outpatient care.

HHS officials said mental health services generally amount to only about 5 percent of a large group insurance plan's spending, so there should be limited impact on premiums. They said the small group and individual plans being made available through health insurance exchanges already reflect the parity requirements.

Officials at America's Health Insurance Plans, a trade group, said they were still reviewing the rule.

Gil Kerlikowske, director of the National Drug Control Policy Office at the White House, said the rule builds on the need to treat drug problems as a public health issue and not just as a criminal justice issue. He said about 23 million Americans have a substance abuse disorder, but only about 1 in 10 receive the treatment they need.

"Access to drug treatment shouldn't be a privilege to a few who can afford it. It should be provided to everyone who needs it," Kerlikowske said.

Lawmakers instrumental in passing the health parity law had grown impatient with how long it was taking to fully implement it.

"While I am clearly frustrated that this wasn't done sooner, I understand that they had a lot of other things on their plate," said former Rep. Patrick Kennedy, D-R.I., adding that it would be ungrateful not to take into account progress made on other fronts through the Affordable Care Act.

Kennedy went public about his own struggle with addiction after crashing his car into a barricade near the Capitol in 2006; he was diagnosed with bipolar disorder after winning election to Congress in 1994.

"Ending insurance discrimination against pre-existing conditions is the single biggest mental health bill we could get," Kennedy said.



It's about time. We will never end the stigma of mental illness until things like this are changed. People with depression, bipolar disorder, anxiety disorder, schizophrenia, etc. suffer just like someone who suffers from diabetes or cancer, and there is a huge biophysical component to these diseases. It shouldn't be treated any differently.


The U.S. has some of the strictest laws against illegal drugs in the world, yet is the greatest user of them.

Smoke, drink, get fat, don't exercise, use drugs and the compassionate State will pay for all of one's self-inflicted physical abuse.

There's no further need for self-control or personal responsibility. Big Brother will take care of all.

We have front row seats to the financial and fiscal bankruptcy of the U.S. through bureaucratic central planning.

"O, wonder!
How many goodly creatures are there here!
How beauteous mankind is! O brave new world,
That has such people in't!"

- The Tempest (V, i)


Pterocarya frax...

When it comes to the gun violence issues, the only 2 solutions I have ever heard from the pro gun side is to arm more people and address the mental health issues.

Finally Obama has addressed one of them. You folks better not complain.


Re: "Finally Obama has addressed one of them."

How does merely "addressing" the issues of pre-existing conditions and expanding coverage for mental illness and substance abuse through a diktat equate to adequately funding it?

As Mr. “I've been burned already with a website” helped to illustrate, mandates are not the same as solutions.

BTW, as noted in the above article: "The law, signed by President George W. Bush,"




Does anyone know what our government is doing. We pass laws so its OK to smoke weed. Now we add another law to the dips healthcare that we taxpayers will now pay for those who have a drug habit and need treatment.WHAT?

Dr. Information

So now tax payers will be on the hook for drug users treatment, which 9 times out of 10 fails over and over again. The working class always gets it stuck to them.


Given that mental illness DOES have physical causes, and that abusers DO end up with physical ailments, it makes sense that such should be treated as any other illness or injury. Of course, there's more to it than that under Obamacare...

Remember: ALL of your medical records are accessible by a plethora of government employees. ALL of your medical records will be centralized and cross referenced on a huge database. While this might sound okay (and in theory, the cross referencing is a legitimate potential life-saver), I guarantee you that the same database will be used in a discriminatory fashion should your history ever, EVER show anything that might remotely be construed as a mental health issue.

Keep in mind, too, that certain drugs used in the treatment of some mental health issues are also used for other things. But once those drugs show up in your records, hello, cross referencing, and welcome to no longer being able to exercise certain rights.

Am I opposed to mental health care? No. Am I opposed to rehab? No again. Am I opposed to medical records being held in any but the strictest confidence (outside of the existing rules that require notification should a mental health patient indicate to his or her therapist there's a danger to the patient or to others)? Oh, yeah! And under Obamacare, there will be no such thing.

The Hero Zone's picture
The Hero Zone

But...but...government documents are supposed to be sealed and stuff. Nobody is ever supposed to leak or release them! No individual nor "anonymous" organization should be able to see that stuff. Right? You're scaring me, Sam! What if someone wanted to run for office but didn't want life details, surgeries, etc. to come up?


"Ryan married actress Jeri Ryan in 1991; together they have a son, Alex Ryan, born 1994. They divorced in 1999 in California, and the records of the divorce were open but their custody documents were sealed at their mutual request. Five years later, when Ryan's Senate campaign began, the Chicago Tribune newspaper and WLS-TV, the local ABC affiliate, sought to have the records released. On March 3, 2004, several of Ryan's GOP primary opponents urged release of the records.[4] Both Ryan and his wife had agreed to make their divorce records public, but not make the custody records public, claiming that the custody records could be harmful to their son if released. On March 16, 2004, Ryan won the GOP primary with 36 percent to 23 percent against Jim Oberweis, who came in second.[5] Obama won the Democratic primary, with 53 percent to 23 percent against Dan Hynes, who came in second.
On March 29, 2004, Los Angeles Superior Court Judge Robert Schnider ruled that several of the Ryans' custody records should be opened to the public.[6] The following week, on April 2, 2004, Barack Obama called on Democrats not to inject them into the campaign.[7] The Ryan campaign characterized Obama's stance as hypocritical, because people they alleged to be Obama's backers had been emailing reports about the divorce records prior to Judge Schnider's decision, and urging the press to seek to open them.[7]
In May 2004, two polls were conducted statewide. The Chicago Tribune poll found Ryan trailing Obama 52% to 30%[8] while the Sun Times reported that he was trailing Obama 48 percent to 40 percent in the U.S. Senate race, according to a Daily Southtown poll of 500 likely Illinois voters.
On June 22, 2004, after receiving a report from the referee, Judge Schnider released the files that were deemed consistent with the interests of Ryan's young child. In those files, Jeri Ryan alleged that Jack Ryan had wanted her to perform sexual acts with him in public in sex clubs in New York, New Orleans, and Paris, although no sex occurred. Jeri Ryan described one as "a bizarre club with cages, whips and other apparatus hanging from the ceiling."[9] The decision to release these files generated much controversy because it went against both parents' direct request, and because it reversed the earlier decision to seal the papers in the best interest of the child, who had special needs. On the same day, Jim Oberweis, Ryan's defeated opponent in the GOP primary, commented that if the allegations were true, "it would end the candidacy."[9]
Ryan's campaign indeed ended less than a week after the custody records were opened, and Ryan officially filed the documentation to withdraw on July 29, 2004. The same party leaders who called for Ryan's resignation chose Alan Keyes as Ryan's replacement in the race; Keyes lost to Obama, 27% to 70%."

So I guess some sealed records aren't so sealed even in the confidence of the law or those who were involved, perhaps like a doctor and patient.

The Big Dog's back

You right wingers should be ecstatic that mental health is covered.

Dr. Information

We are. Call and get an appointment today please.

The Big Dog's back

So if one of you right wingnuts has a medical emergency in another state, where you are unconscious, nobody with you, and need immediate medical attention, but have allergic reactions to some medications, you wouldn't want them to have access to your medical info?

Dr. Information

Horrible example. Please give us a better one.