APA Calls on Congress to Enforce, Strengthen Behavioral Health Parity Laws

The American Psychological Association (APA) is calling on Congress to enforce and improve the Mental Health Parity and Addiction Equity Act (MHPAEA), arguing that the legislation’s long-time shortcomings have become even more clear amid the pandemic. 

MHPAEA has been the law of the land since 2008. It mandates that employers offer mental health coverage that’s no more restrictive than the limitations they put on medical and surgical health coverage. However, as behavioral health providers frequently point out, the MHPAEA isn’t ensuring parity the way that it’s intended to. 

Brian Smedley, APA’s Chief of Psychology in the Public Interest, testified to Congress Thursday in hopes of getting that point across. He asked lawmakers to do a better job making sure payers comply with the law and to close loopholes that leave people without adequate behavioral health coverage. 


“Congress can do more to ensure adequate oversight and enforcement of insurers’ compliance with the law,” Smedley said.

He pointed to a 2019 report from the actuarial and consulting firm Milliman to support his point. For the analysis, researchers dug into data from more than 37 million workers and their dependents, all of whom had commercial preferred provider organization (PPO) plans between 2013 and 2017, the period included in the report.

In the end, Milliman found that U.S. employees were about five times more likely to go out of network to visit behavioral health providers than they were to visit out-of-network primary care providers. On top of that, the disparities in coverage only widened over the five-year period researchers analyzed. 


Now, the coronavirus has only made things worse, Smedley said, pointing to the increase in the prevalence of stress, anxiety, depression and substance use disorders (SUD) that it’s caused nationwide. 

“The COVID-19 pandemic worsened what was already a mental health tsunami in this country,” Smedley said. “Research suggests we may be grappling with the mental health impact of this pandemic long after the pandemic itself ends. We must do more to improve access to mental health treatment for those who need it.”

Specifically, Smedley and the APA called on Congress to pass the Parity Enforcement Act of 2021 (H.R. 1364), which would give the Department of Labor more power to enforce the law, and to support the Tele-Mental Health Improvement Act (H.R. 2264), which would improve access to telehealth services for mental health treatment by private sector health insurance plans during COVID-19.

On top of that, APA called on Congress to put more funding toward federal oversight and enforcement of the MHPAEA, as well as to close a loophole that allows states to opt out of parity requirements for state employees, many of whom are frontline workers currently putting themselves at risk amid the pandemic.

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