MHW: HHS Brief Outlines Parity Protections In ACA Implementation

HHS Brief Outlines Parity Protections In ACA Implementation

Mental Health Weekly February 25, 2013

Editor’s Note: HHS officials on Feb. 20 released the final rule on the Essential Health Benefits under the Affordable Care Act (ACA). Mental Health Weekly will feature reaction from the mental health community in its March 4 issue.

The Affordable Care Act (ACA) will expand mental health and substance use disorder benefits and parity protections for 62 million Americans, according to a new research brief released Feb. 20 by the U.S. Department of Health and Human Services’ (HHS’s) Office of the Assistant Secretary for Planning and Evaluation (ASPE).

In total, through the ACA, 32.1 million Americans will gain access to insurance coverage that includes mental health and/or substance use disorder benefits that comply with federal parity requirements, and an additional 30.4 million Americans who currently have some mental health and substance abuse benefits will benefit from the federal parity protections, according to the ASPE brief.

The ACA and its implementing regulations, building on the Mental Health Parity and Addiction Equity Act (MHPAEA), will expand coverage of mental health and substance use disorder benefits and federal parity protections in three distinct ways: (1) by including mental health and substance use disorder benefits in the Essential Health Benefits package; (2) by applying federal parity protections to mental health and substance use disorder benefits in the individual and small-group markets; and (3) by providing more Americans with access to high-quality healthcare that includes coverage for mental health and substance use disorder services, according to the brief.

Beginning in 2014 under the law, all new small-group and individual market categories will be required to cover 10 Essential Health Benefit categories, including mental health and substance use disorder services. They will also be required to cover them at parity with medical and surgical benefits.

HHS states that the Essential Health Benefits final rule, released Feb. 20, ensures that consumers purchasing insurance can be confident that their health plan will provide the

care they need if they get sick. As a result of behavioral health benefits being included in the Essential Health Benefits, Americans accessing coverage through non-grandfathered

plans in the individual and smallgroup markets will now be able to count on mental health and substance use disorder coverage that is comparable to their general medical and surgical coverage, according to the brief.

Under this approach, 7.1 million Americans currently covered in the individual market who currently have some mental health and substance use disorder benefits will have access to coverage of Essential Health Benefits that conforms to federal parity protections as provided for under the ACA and the MHPAEA.

In addition, because the application of parity to the Essential Health Benefits package will also apply to those currently enrolled in nongrandfathered plans in the small group market, 23.3 million current enrollees in small group plans will also receive the benefit of having mental health and substance use disorder benefits that are subject to the federal parity law.

For a copy of the ASPE Research Brief, visit http://aspe.hhs.gov.