Final Rules on Equal Coverage for Mental Health Care Receive Mixed Reactions

The departments of Health and Human Services (HHS), Labor, and the Treasury issued new rules on Sept. 9 requiring health plans to provide the same level of coverage for mental health and substance use disorder (SUD) treatment as they do for medical and surgical conditions. While some praised the move for improving access to mental health care, others expressed concerns about its potential effect on coverage and insurance costs.
“Like medical care, mental health care is vital to the well-being of America’s workers,” Acting Secretary of Labor Julie Su said. “The final rules issued today make it easier for people living with mental health conditions and substance use disorders to get the life-saving care they often need.”
The rules also require health plans to collect and review data to ensure they aren’t making it harder to access mental health care than medical care, particularly through policies such as prior authorization.
If they find problems, the insurer must fix them. The rules also set clear guidelines on how to assess and report these practices and who can access the reports.
The rules also formally clarify and implement a provision of the Consolidated Appropriations Act of 2023 that removes the current ability of some self-funded government health plans (non-federal, such as state or local government employee plans) to opt out of complying with the mental health parity rules under the MHPAEA.
“The final [MHPAEA] rule will have severe unintended consequences that will raise costs and jeopardize patients’ access to safe, effective, and medically necessary mental health support,” the groups said in the joint statement.
The group of organizations said that the rules fail to address key issues such as a shortage of mental health providers and expanding telehealth resources.
“This rule promotes none of these solutions. Instead of expanding the workforce or meaningfully improving access to mental health support, the final rule will complicate compliance so much that it will be impossible to operationalize, resulting in worse patient outcomes,” the groups said.
The National Alliance on Mental Illness (NAMI), one of 17 organizations, said the rules will prioritize mental health parity and improve enforcement mechanisms.
“These changes reflect what we’ve all known for a long time: we need to do better for people with mental health conditions. There is no health care without mental health care.”
The final rules will take effect from Jan. 1, 2025, for most group health plans.