Oct 21, 2021

For decades, MAMH has been advocating to ensure that people with mental health and substance use conditions receive the same level of health insurance benefits and access to services as people with physical health conditions.

This is known as parity. In 2008, the federal Mental Health Parity and Addiction Equity Act became law, but it still is not fully enforced.

For example, many insurers continue to impose “nonquantitative treatment limits” such as preauthorization requirements for behavioral health services and unequal limits on residential treatment limitations. “Fail-first” protocols, which require a patient to try and fail on a cheaper alternative to a mental health medication before a higher-cost medication is approved, is one of the most common types of coverage restrictions.

Treating people with behavioral health conditions differently than people with physical health conditions is discriminatory. Benefits offered by health plans for behavioral health care must be comparable to those offered for physical health care, and not subject to more restrictive financial requirements or treatment limitations.

In 2018, The Kennedy Forum released a technical paper assessing the relative strength of state parity laws in ensuring to effective parity enforcement. The Satcher Health Leadership Institute at the Morehouse School of Medicine and The Kennedy Forum developed a Statutory Coding Instrument (SCI) that evaluated state laws across 10 dimensions, including coverage of mental health and substance use services, requirements for nonquantitative treatment limitations, state agency enforcement and reporting. Massachusetts scored 61 out of 100 points, earning a grade “D”. We can do better than this.

Bills filed in the MA legislature by Sen. Cindy Friedman and Rep. Ruth Balser (S.675/H.2065) would require health insurance plans to provide mental health benefits on a nondiscriminatory basis, including the diagnosis and medically necessary treatment of any mental health or autism spectrum condition. These bills would begin address insurance barriers such as onerous and time-consuming approval processes and provide consumers with more opportunities to assert their parity rights.

Ensuring behavioral health parity has never been more important than it is today. The demand for mental health and substance use services grew significantly during COVID and has not abated. MAMH joins the Children’s Mental Health Campaign and many other mental health advocates to support legislation that promotes and supports effective parity implementation.

“Treating people with behavioral health conditions differently than people with physical health conditions is discriminatory.”

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