The issue of coverage for mental health and substance use disorder (MH/SUD) treatment and medical/surgical treatment has been a health policy concern in the United States for many years and greatly affects the lives of millions of Americans suffering from mental illness and substance use disorders. Federal agencies including the Department of Health and Human Services (HHS), the Department of Labor (DOL), the Department of Treasury, the Office of National Drug Control Policy (ONDCP), the Department of Veterans Affairs (VA), and many others have undertaken various efforts to achieve parity in the provision of health insurance coverage for behavioral health care and general medical and surgical care. These agencies have coordinated with States to enforce the parity provisions contained in key legislation such as the Federal Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and the Patient Protection and Affordable Care Act (ACA) of 2010—the former required full parity in coverage and treatment limitations across the majority of private health plans, and the latter extended those protections to many individual and small group health insurance plans. The White House Mental Health and Substance Use Disorder Parity Task Force (Task Force), an inter-agency task force established in March 2016, identified best practices for Federal agencies with regard to parity compliance and implementation, and determined areas of further action to improve parity enforcement.
More recently, in December of 2016, Section 13002 of the 21st Century Cures Act directed the Secretary of HHS to convene a public listening session with Federal government representatives and key stakeholders to obtain input on issues related to improving enforcement of Federal mental health parity requirements, with the goal of ultimately producing an action plan to improve Federal and State coordination on enforcement.
Key stakeholders include Federal and State government representatives, insurance representatives, mental health care providers, employers, and consumers and their advocates. Stakeholders were to also be provided with an opportunity to submit written comments.
To fulfill this goal, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) within HHS, along with representatives from the Departments of Labor and Treasury and the Office of Personnel Management, held a public listening session on parity enforcement in Washington, D.C. on July 27, 2017, and accepted written comments on this issue from stakeholders and interested parties from July 3 to August 10, 2017, via a dedicated e-mail address. Over 40 comments were received, including 20 in person testimonies, from a wide range of stakeholders, including consumers and consumer advocates, providers, and other interested parties. Those who spoke at the listening session also provided a written copy of their testimony.