A young woman sits on a couch together with her therapist.
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The Biden administration plans to crack down on health insurance policy that discriminate against individuals who need mental health care and substance abuse treatment.
A proposed rule published Tuesday by the Health and Human Services, Labor and Treasury departments goals to push health insurers to comply with the Mental Health Parity and Addiction Equity Act.
That law, which was passed in 2008, requires insurance policy that cover mental health care and substance abuse treatment to supply the identical level of coverage for these services as they do for other illnesses.
White House domestic policy advisor Neera Tanden told reporters in a call Monday that too many insurers are evading the law and making it difficult for patients to access mental health care.
Insurance policy often don’t provide enough therapists in network, which forces patients to hunt care out of network and pay more. Patients also often must get permission from their insurer to hunt treatment or have their claims denied leaving them with the bill.
“This has meant thousands and thousands of people that have insurance are paying out of pocket after they shouldn’t must,” Tanden said.
Greater than 1 in 5 adults within the U.S., or 58 million people, live with a mental illness, based on the National Institute of Mental Health.
The proposed rule would require insurance policy to guage how their coverage policies impact patients’ access to mental health and substance abuse treatment, Tanden said.
Insurers could be required to take motion in the event that they usually are not in compliance with the law, she said. This might include adding more therapists to the insurance network if patients are in search of care out of network too often, Tanden said.
The proposed rule will undergo a 60-day public comment period before it’s finalized.
The health insurance industry’s lobby group AHIP in an announcement Tuesday attributed the challenges patients face in accessing mental health care to a shortage of clinicians. Kristine Grow, a spokesperson for AHIP, said the industry has been working to expand access through telehealth, recent technologies and integrating mental and physical health.
Grow said AHIP believes that everybody must have access to mental health care that’s on par with physical health. AHIP is evaluating the Biden administration’s proposed rule, she said.
A survey published in July of nearly 2,800 patients found that individuals with insurance face more challenges accessing mental health services than other varieties of medical care.
Nearly 40% of individuals enrolled in insurance through their employer needed to seek more costly mental health care or substance abuse treatment out of network, based on the survey conducted by the research institute NORC. By comparison, 15% of individuals in search of physical health care went out of network.
Greater than 50% of patients reported that their insurance denied coverage three or more times for mental health or substance abuse services, compared with 33% who reported the identical for physical health care.
And nearly 60% of those surveyed who sought mental health care or substance abuse treatment didn’t receive any care in no less than one instance.