Colorado is a step closer to building a foundation for mental health parity. This move codifies federal parity regulation at a state level.

On Feb. 10, the Colorado House of Representatives bipartisanly voted 54-9 to approve HB25-1002. The bill would require health plans to make judgments about the appropriateness of care based on guidance created by behavioral health industry medical expert bodies. 

“Health care coverage decisions should be made based on the best evidence-based recommendations of health care professionals, not on profit margins,” Rep. Kyle Brown, a Democrat from Louisville, Colorado, said in a statement. “Right now, too many Coloradans struggle to receive the care they need while insurance companies continue to deny coverage for behavioral health care.

“This bill helps standardize insurance coverage decisions so Coloradans can actually access the behavioral health services they pay for.”

The bill would also codify the most recent federal parity law, the Mental Health Parity and Addiction Equity Act (MHPEA) of 2008, into the state code. It would also require health plans to make determinations of medical necessity for care using the guidelines set by organizations such as the American Academy of Child and Adolescent Psychiatry, the American Association for Community Psychiatry and the American Society of Addiction Medicine.

For decades, behavioral health providers and patients have maintained that behavioral health benefits are treated worse than physical health benefits, often seeing it as an institutional internalization of stigma towards those with behavioral health conditions. While Congress has passed laws to ensure that physical health benefits and behavioral health benefits are treated in similar ways — with parity — many advocates say that federal parity laws and the rules that execute them lack meaningful enforcement mechanisms and have serious holes.

A state legislative action takes the issue to a local level with a greater degree of permanence than federal rules. In September, the Biden administration finalized rules reworking how health plans measure and demonstrate parity. That rule has recently been challenged in court by an insurance industry group that filed a suit that corresponded with the inauguration of President Donald Trump. Following a historic U.S. Supreme Court ruling, it’s much easier to challenge federal rules on the grounds that they overstep the letter of the law.

“When insurance doesn’t cover claims, that drives up costs for families, and it makes it harder for Coloradans, especially young people, to receive critical care, as too many still don’t receive care at all,” Rep. Lindsay Gilchrist, a Democrat from Denver, said in a statement. “Colorado has made major strides in recent years to invest in behavioral health care, and this bill carries on this work by ensuring providers can’t deny insurance coverage for medically necessary health care.”

A fiscal note for the bill states that the bill, if enacted, would not impact the Colorado state government’s budget in a meaningful way.

“Since these departments already enforce federal mental health parity requirements, additional work required to enforce requirements codified into state law is expected to be minimal,” the note states, referring to the Colorado Departments of Health Care and Financing (HCPF) and Regulatory Agencies (DORA). 

Gilchrist and Brown were the bill’s sponsors in the Colorado House of Representatives. In the Senate, the bill is sponsored by Sens. Byron Pelton and Judy Amabile.