For many Americans, access to mental health services remains a challenge. Years after the 2008 mental health parity law, certain state exchange health plans do not offer the same level of mental health benefits as compared to physical health benefits, according to a new report by the advocacy group Mental Health America (MHA).
The report found that about 42.5 million American adults suffer from mental illness. Roughly one in five--8.1 million--are uninsured, while only two in five report receiving treatment. This rate varies from 57 percent in Vermont to less than 30 percent in the lowest-ranking states. In addition, nearly 20 million have a substance use problem, while 8.8 million report having serious thoughts of suicide.
MHA found that certain plans include details regarding coverage, while others do not. For instance, a Blue Cross Blue Shield of Alabama plan mentions only that it covers mental health and substance use outpatient services but doesn't provide any further explanation about exclusions.
Coverage varies as well. Blue Cross Blue Shield of North Carolina's blue Options plan offers a variety of services, including screening and intensive therapy, and has fewer exclusions that other plans, the report mentions. Another BCBS plan in Georgia excludes treatment of behaviorial disorders and cognitive rehabilitation.
Additionally, many plans do not specify what and how many services they cover. This means consumers may find out that insurers won't pay for their treatment until after they've received care, according to the report. On top of that, the news magazine 60 Minutes found that insurers are denying mental health claims for patients who need long-term mental healthcare, FierceHealthPayer previously reported
"Parity is in its infancy. Most plans know the numerical requirements around cost-sharing, but few have taken seriously the requirements around equity--around access through networks and barriers to care through prior authorization," said Mike Thompson, healthcare practice leader at PricewaterhouseCoopers, according to Kaiser Health News.