New Rules to Expand Mental Health Coverage Finalized


Health insurers must now treat mental health and substance-abuse issues no differently than they do physical illnesses, according to a final rule issued by the Obama administration. Co-payments, deductibles and visit limits for mental health visits must be similar to those required for physical health visits, according to the new rule.

The rule also extends to residential and intensive outpatient treatment for addiction and mental illness. The new rules apply to private insurers and to employer-run health plans that include 50 or more workers, but do not apply to people in government health insurance programs like Medicaid and Medicare.

The announcement comes five years after passage of the Mental Health Parity and Addiction Act, which was signed into law in 2008 by President George W. Bush. At the time, the act was celebrated as groundbreaking for those suffering from mental illness, but its implications for how insurers were to cover certain types of psychiatric emergencies and recovery periods remained unclear. The new rules serve to clarify the law’s practical implications, though many insurance companies were already abiding by its guidelines since it was passed in 2008.

Many lauded clarification of the law as an important step in broadening the reach of mental health services. Finalization of the law’s rules was one of the Obama administration’s stated priorities following a rash of violent shootings including one at Sandy Hook Elementary School in Newtown, Connecticut, which left 20 children, six employees and the shooter dead.

The National Institute of Mental Health reports that approximately a quarter of Americans over the age of 18 suffers from some type of mental illness every year. According to Health and Human Services Secretary Kathleen Sebelius, the new rules will expand benefits and equal coverage protections to approximately 62 million Americans.