Biden mental health care push targets insurers

The Biden administration plans to crack down on health insurance plans that discriminate against people in need of mental health care and substance abuse treatments.

The proposed rule, published by the Health and Human Services, Labor and Treasury departments on Tuesday, aims to push health insurers to comply with the Mental Health and Addiction Equity Act.

This law, passed in 2008, requires that insurance plans that cover mental health care and substance abuse treatments provide the same level of coverage for these services as they do for other illnesses.

White House domestic policy adviser Neera Tanden told reporters on a conference call Monday that a lot of insurance companies are skirting the law and making it difficult for patients to access mental health care.

Insurance plans often don’t provide enough in-network therapists, forcing patients to seek out-of-network care and pay more. Patients also often have to get permission from their insurance company to seek treatment or have their claims denied and left with the bill.

“This means that millions of people who have insurance pay out of pocket when they don’t have to,” Tanden said.

According to the National Institute of Mental Health, more than one in five adults in the United States, or 58 million people, suffer from a mental illness.

Tanden said the proposed rule would require insurance plans to evaluate how their coverage policies affect patients’ access to mental health and substance abuse treatments.

She said insurance companies would be required to take action if they did not comply with the law. This could include adding more therapists to the insurance network, Tanden said, if patients frequently seek out-of-network care.

The proposed rule will be subject to a 60-day public comment period before it is finalized.

A survey of nearly 2,800 patients published in July found that people with insurance faced greater challenges accessing mental health services than other types of medical care.

Nearly 40% of people enrolled in insurance through their employer have had to seek out more affordable mental health care or drug treatment out of network, according to the NORC survey. By comparison, 15% of people who seek physical healthcare are out of the network.

More than 50% of patients reported that their insurance refused coverage three or more times for mental health or substance abuse services, compared to 33% who reported doing so for physical health care.

And nearly 60% of those surveyed who sought mental health care or substance abuse treatment had not received any care in at least one instance.