A Tale of Two States: Do Consumers See Mental Health Insurance Parity When Shopping on State Exchanges?

In Psychiatric Services, Kelsey Berry and colleagues, including Colleen Barry, present an analysis of parity compliance in how behavioral health benefits are presented to consumers shopping on health insurance exchanges established by the Affordable Care Act.  All insurance plans sold on the exchanges are required to offer mental health and substance use disorder benefits in compliance with requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The researchers reviewed summaries of benefits documents available to potential enrollees for all insurance products offered on two state-run exchanges. Berry and colleagues find discrepancies in the benefits included in the plans, in the ways that the benefits are described to potential enrollees, and in financial requirements imposed on behavioral health benefits versus medical-surgical benefits.  Additionally, they also find that many plans use language that could lead enrollees to believe pre-authorization is required before accessing behavioral health treatment.  Monitoring of mental health parity compliance is critical to determine if these regulations are fulfilling their promise to increase fairness and efficient operation of the insurance market.