Insurers Slam Mental Health Parity Plan
Politico October 18, 2023
The Biden administration has proposed expanding requirements for insurers to cover mental health and substance use treatment as they do for other care — and insurers aren’t happy.
The administration received more than 9,000 responses during the comment period, which closed Tuesday. The regulations would expand requirements under a 2008 law and mandate that insurers analyze their coverage to ensure equivalent access to mental health care based on outcomes.
Organizations like the American Hospital Association and the American Medical Association, plus mental health advocacy groups like the Kennedy Forum, have been enthusiastic about the proposal.
Insurers want changes.
AHIP, the lobbying group for insurers, argued workforce shortages are the main driver of barriers to care.
The Blue Cross Blue Shield Association said that all deserve affordable access to care, and their plans work to ensure access. However, BCBSA argued that the regulations could have “unintended consequences,” including impeding access and imperiling patient safety by potentially forcing plans to accept lower-quality providers. It called for a more “comprehensive approach” that would address workforce shortages, licensing and other issues.
“Parity is an important part of that puzzle, but we can’t address the mental health crisis by only addressing payment and parity,” David Merritt, SVP of policy and advocacy at BCBSA, told Pulse.
The Alliance of Community Health Plans and the ERISA Industry Committee, or ERIC, similarly agreed with the administration’s aims to ensure access but panned the proposal.
“The proposed regulations are so unworkable, it is unclear how compliance could ever be achieved while continuing to offer these important benefits,” said James Gelfand, president of ERIC, which represents large employers’ benefit interests.
The groups, to varying degrees, took issue with proposed requirements for plans to analyze the impact of practices intended to limit unnecessary care. Gelfand argued the administration is attempting to dissuade most of those limitations from being implemented.
BCBSA said the administration should drop a requirement that plans examine whether such limitations are more restrictive than for “substantially all” medical and surgical benefits. ACHP wants the administration to offer more clarity and said it has “significant concerns” about the provision.
View from Congress: Rep. Virginia Foxx (R-N.C.), chair of the House Education and the Workforce Committee, said the administration is going beyond its authority.
“The … proposed rules will serve only to weaken parity compliance by giving prominence to bureaucratic reporting, paperwork, and audits,” Foxx wrote. The panel’s top Democrat, Bobby Scott of Virginia, and health subcommittee ranking member Mark DeSaulnier (D-Calif.) backed the proposal in a letter first shared with Pulse but said