On Wednesday, October 3, a new report was released, Evaluating State Mental Health and Addiction Parity Statutes: A Technical Report, ranking the fifty states A through F on whether or not they are providing parity access to mental health and substance abuse treatment consistent with the federal law. That law generally requires health insurers to provide mental health coverage equal to health care coverage. The report finds that 32 states do not ensure equal coverage for behavioral health.

The report was released on Wednesday since it was the tenth anniversary since President George W. Bush signed the Mental Health Parity and Addiction Equity Act (MHPAEA). Referred to as the Federal Parity Law it requires insurers to cover illnesses of the brain, such as
depression or addiction, no more restrictively than illnesses of the body, such as diabetes or
cancer. In addition, the enactment of the Affordable Care Act (ACA) reinforced the law by requiring health insurance policies sold on the ACA exchanges to provide mental health and substance use coverage as one of the essential benefits that policies must include.

Based on the results of the assessments, the states with the highest grades and points for their statutes are: Illinois (A, 100), Tennessee (C, 79), Maine (C, 76), Alabama (C, 74), Virginia (C,71), and New Hampshire (C, 71). In its assessment the report stated that the laws “of most of these higher-scoring states have room for improvement.”

The state statutes with the lowest grades and points are Wyoming (F, 10), Arizona (F, 26), Idaho (F, 36), Indiana (F, 38), Alaska (F, 43), and Nebraska (F, 43). Wyoming is singled out for being the only state not to address mental health parity in its statutory code. The report card is based on a review of state statutes based on ten different provisions regarding the coverage and enforcement of mental health and substance use disorder treatment coverage.

Much of the motivation for the effort and study comes from the Kennedy-Satcher Center for Mental Health Equity. The center is led by former Congressman Patrick Kennedy (D-RI) and former Surgeon General David Satcher. Kennedy was the sponsor of the original legislation and worked with his father, Senator Edward Kennedy (D-MA), to attach the legislation to moving legislation in late 2008. Patrick Kennedy has been a prominent advocate for greater access to mental health and substance use treatment and coverage. He has been open about his own personal challenges with substance abuse and mental health and most recently he served on this President’s commission to address opioids.