On July 25th, the Biden Administration and U.S. Departments of Labor, Health and Human Services, and Treasury released proposed rulemaking for the Mental Health Parity and Addiction Equity Act (MHPAEA) with the goal of holding private insurance companies accountable for mental health and addiction services coverage and increasing parity between physical health coverage and mental health coverage.

According to the Fact Sheet released by the Administration, “too many Americans still struggle to find and afford the care they need. Of the 21% of adults who had any mental illness in 2020, less than half received mental health care; fewer than one in ten with a substance use disorder received treatment. Research shows that people with private health coverage have a hard time finding a mental health provider in their health plan’s network… insurers too often make it difficult to access mental health treatment, causing millions of consumers to seek care out-of-network at significantly higher costs and pay out of pocket, or defer care altogether.”

The new proposed rules would take the following steps to strengthen MHPAEA and require private insurance companies to comply with the law:

  • Require health plans to make changes when they are providing inadequate access to mental health care.
  • Make it clear what health plans can and cannot do, using specific examples to illustrate what is not allowed.
  • Close existing loopholes and require more health plans to comply with MHPAEA.

The New Proposed Rulemaking (NPRM) has not yet been posted on the Federal Register, but it will be open for public comment for 60 days once posted.

During his 2021 State of the Union Address, President Biden highlighted mental health as one of the key priorities of his bipartisan unity agenda, and this rule is a step by the Administration to address the need for better access to mental health services.