Mental Health Insurance Parity: How Full Is the Glass?

Abstract

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, the federal law requiring parity in coverage for mental health and substance use disorder (MH/SUD) services and medical/surgical services offered in group health insurance plans, was the culmination of over fifty years of advocacy and debate. Advocates had pushed for parity in response to long-standing differences in the generosity of private insurance benefits for MH/SUD vs. medical/surgical services that left many with mental disorders without sufficient financial protection from the costs of treatment. The Affordable Care Act (ACA), which expanded coverage of MH/SUD and other services for millions of Americans, extended parity requirements to many other populations. This chapter discusses the history of parity and related policies, their primary goals, and research that examines the effects of MHPAEA and ACA parity policies. It will then discuss market failures that remain for MH/SUD services.