Tens of millions of mentally ill and drug-addicted Americans will get expanded access to treatment under regulations unveiled Friday that require insurers to provide equal coverage for behavioral and medical health problems. [WATCH VIDEO]
The rule amounts to a formal government finding that treatment for mental illness and substance abuse is as important to a person’s health as medical or surgical care.
It also reflects action on the last of 23 executive measures announced in January as part of the administration’s effort to stem gun violence in the wake of last year’s elementary school massacre in Newtown, Conn.
“This is the largest expansion of behavioral health coverage in a generation,” Health and Human Services HHS Secretary Kathleen Sebelius declared during a speech Friday morning in Atlanta.
The Labor and Treasury departments also worked on drafting the regulations, with officials poring over roughly 5,400 public comments.
Labor Secretary Tom Perez said the final language would end discrimination against the mentally ill and addicted, ensuring that they are no longer the neglected “stepchildren” of the American healthcare system.
Historically, those suffering from the ailments “all too frequently suffered in silence,” Perez told reporters Friday morning.
Nine in 10 Americans with substance abuse disorders and 60 percent of those with a mental health condition don't receive the care the need, administration officials said.
Together with provisions set out in the Affordable Care Act, the regulations announced Friday would expand health benefits to an additional 62 million people, according to administration estimates.
The rule governs how large group health plans offer coverage for mental health and substance abuse conditions, requiring that it be comparable to coverage for medical or surgical care.
It includes language making clear that insurance companies provide consumers with information about the standards they use to evaluate coverage, especially when they reject claims, Sebelius said.
In particular, the companies must disclose how they decide what services are medically necessary, and that is an appealable decision under the regulations.
Protection will now extend to intermediate levels of care — the services that fall somewhere between hospital care and a visit to the doctor.
Sebelius said the rule builds on strides made in recent years to expand access to mental health and addiction services. Most large health plans, for instance, have eliminated high cost-sharing for behavioral healthcare services, and stopped charging different deductibles for mental health and substance abuse services.
The affordable care act provides similar reforms for individual and small group plans, she said.
“The law's benefits enhance prevention and treatment of mental illness and addiction,” Sebelius said.
President Obama’s gun violence task force, convened in the aftermath of the Connecticut shooting spree, focused heavily on mental health issues.
One of the 23 executive actions announced by Obama at the group’s recommendations was to finalize mental health parity regulations.
With Friday’s action, some progress has been made on each of the actions, said Sarah Bianchi, Vice President Biden’s economic and domestic policy director.