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On November 8th, 2013, the parity implementation ruling was finally released to address behavioral health discrimination. The long awaited ruling has garnered reactions among lawmakers, behavioral health advocates, agencies, and insurance carriers.
The Obama Administration
Secretary of the Department of Health and Human Services, Kathleen Sebelius, confidently announced, “we are finally closing those gaps.” Although receiving backlash about the shortcomings of the HealthCare.gov website, the administration is able to partially check off another executive action on its list. And the Office of the Vice President, remarked “Parity is not just a buzzword. It has real impact for the millions of people who are experiencing or will experience mental illness or addiction.”
Congressional Statements
Several US Senators and Representatives have released statements on the final parity ruling. Below are just a few press releases:
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Joint release from Reps Napolitano (D-CA), Ryan (D-OH), Barber (D-AZ), Tonko (D-NY) and Lee (D-CA)
Mental Health Advocates
As the dust begins to settle after individuals were given access to the lengthy document, advocates pointed out that while the rule closes some gaps, there are still issues remaining. The final ruling clarified a number of gray areas from the interim rules in 2010, but does not apply to Medicaid managed care plans, upcoming guidance is still expected on this issue. Though the rules were not perfect, they were a huge step in the right direction. Debbie Plotnick, senior director of state policy for Mental Health America, announced on Friday, November 8th, “what a historic day this is, and what a difference it will make to families and individuals who have been discriminated against legally for many, many years.”
Patrick Kennedy expressed conflicted views as well since implementation plans were finally written down, but sadly, it took 5 years. In a recent remark, Kennedy alluded the most important part is whether the regulations will be monitored and enforced. The true test will present itself once a consumer of mental health services enters the appeals process.
Officials at three agencies – the U.S. Treasury’s Internal Revenue Services; the U.S. Labor Department’s Employee Benefits Security Administration; and the U.S. Department of Health and Human Services’ Center for Consumer Information & Insurance Oversight- are working collectively to assist insurers and employers to comply with the parity rules. Each agency will collaborate with state regulators and the National Association of Insurance Commissioners to ensure compliance and to answer questions.
Insurance Companies & Parity Regulations
Some advocates assumed the release Final Rule would be met with resistance from the insurance carriers since they cannot charge more for co-pays, charge mental health consumers separate deductibles, nor restrict visits more than medical/surgical care. Dr. Peter Beilenson (founder of insurance co-op Evergreen Health Cooperative Inc.) instead applauds the decision since people with mental health problems are often underserved. Beilenson further explained, most visits to primary care physicians are because of mental health conditions, such as depression. These individuals should see mental health professionals.