Lawmakers Introduce Parity Reform Effort in Government-Backed Health Plans

Two Democratic senators have proposed changes to the Social Security Act that could ensure parity and integration of behavioral health in government health plans.

Sen. Michael Bennet (D-Colo.) and Sen. Ron Wyden (D-Ore.) announced Wednesday the release of the Better Mental Health Care for Americans Act, a bill that would impact behavioral health provisions of Medicare, Medicare Advantage, Medicare Part D and Medicaid.

“We are experiencing a massive mental health crisis across America, and we urgently need to act to improve access to mental and behavioral health care,” Bennet said in the release.


The bill would alter provisions of the Social Security Act that touch on some of the most significant parts of government-backed insurance.

At its core, the bill would require behavioral health benefits parity with physical health benefits and increase accountability in integrating behavioral health into physical health. The latter point would also impact private health insurance.

Here’s a rundown of other provisions in the bill. (You can find the text of the bill here and a summary from Bennet’s office here.) : 


— Require Medicare Advantage plans to maintain accurate provider directories

— Increase Medicare and Medicaid reimbursements for integrated care within Medicare and Medicaid

— Create a demonstration project for pediatric integrated care in various settings, including schools

— Require the Center for Medicare and Medicaid Services to better align behavioral health payments, quality measures and prevention services

“For too long, mental health care has taken a back seat to physical health in the United States,” Wyden said in the release. “This bill begins to tip the scales by applying mental health parity protections across the health care system, and strengthening penalties on insurance companies that flout the rules.”

Also on Wednesday, the Senate Finance Committee heard U.S. Health and Human Services (HHS) Secretary Xavier Becerra presented the department’s proposed budget for fiscal year 2024.

Becerra’s first item in his presentation was the Biden administration’s proposals to revamp behavioral health as far as the federal government is concerned. The White House’s proposed budget, largely a signal of priorities, includes nearly $660 million in reform efforts.

HHS has proposed giving $334 million in additional funding to the 988 National Suicide Prevention Lifeline, operated by Vibrant Emotional Health; $100 million for mobile crisis response units; increasing the Community Mental Health Services Block Grant by $645 million and the Substance Use Prevention, Treatment, and Recovery Services Block Grant by $700 million; and add $200 million the National Institutes of Health (NIH) budget for behavioral health treatment research, according to Beccera’s presentation.

Parity has been a hot topic in behavioral health for years. Many providers complain that fee-for-service rates set by payers aren’t treated equally compared to physical health care and that behavioral health benefits often come with greater hurdles than other benefits.

In addition to the work in the Senate, the White House said parity is a priority within President Joe Biden’s health care agenda as presented in his two previous State of the Union addresses.

However, parity efforts have largely stalled out in Congress. Even the latest omnibus funding bill — which many advocates weren’t shy about touting as a huge win for the industry — only worked at the edges of the parity issue. It gave the U.S. The Department of Labor more money for enforcement activities and closed a loophole that exempted local health plans for public employees from meeting parity requirements.

“When it comes to mental health parity, Congress passed a landmark law in 2008 based on the proposition that mental health and physical health should be treated equally,” Wyden said in written testimony presented before the committee hearing, referring to the Mental Health Parity and Addiction Equity Act (MHPAEA). “That’s not happening today. Fifteen years after the law was written, insurance companies are still finding ways to drag their feet. …

“The President’s budget takes important steps in that direction, and I’m proud to be working with Senator Bennet to put mental health care on a better footing.”

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