Mental health would have coverage parity with medical care under federal proposal

The Centers for Medicare & Medicaid Services has announced a proposed rule that would require Medicaid managed care patients to receive the same level of coverage for mental health and addiction treatment as they do for medical and surgical care.

If it becomes formalized, the rule would protect low-income Americans insured through Medicaid managed care programs, as well as the Children's Health Insurance Program plans. It would also prohibit managed care plans from enforcing “hard limits” on things like eligible numbers of visits per year, according to Kaiser Health News. Patients also would be protected under the rule regardless of whether states provide benefits under separate plans.

State Medicaid programs would absorb about $150 million in additional costs from the expected rise in access to mental health/behavioral treatments among the 70 million now covered under Medicaid managed care plans, according to Matt Salo, executive director of the National Association of State Medicaid Directors.

The proposed rule comes seven years after the government first attempted to bring parity to mental health and medical/surgical care through passage of the Mental Health Parity and Addiction Act of 2008. But until now, only issues with commercial plans had been addressed by the government. A similar rule to the one proposed Monday has been in effect since 2013 for private insurers.

Some observers are skeptical that the government would aggressively enforce the law because of the ubiquitous stigma of mental illness they say still pervades our society. Moreover, even the law's sponsor told Kaiser Health News, “Patients still face discrimination in their mental health and substance abuse care.”