Mental Health Parity and Addiction Equity Act

Historically, insurance companies have only been required to cover certain mental health disorders (i.e. schizophrenia and bipolar disorders). In recent years more than 250 national organizations that have urged passage of the Act Mental Health Parity and Addiction Equity Act. Under this Act, many other commonly-diagnosed mental disorders including alcoholism and drug addiction are to be treated equitably by health insurers.

After a 10 year hard fought battle, treatment for “alcoholism and other addictions” now must be included in health insurance coverage!

What does this mean for our clients?

Insurance companies will now be required to cover residential rehab programs for addiction/alcoholism, whether or not it is in your policy. Clients will still be required to meet diagnostic criteria, but if they do, insurance must pay.

This is a huge victory for clinicians like myself and anyone who knows that addiction and alcoholism are debilitating diseases that can destroy lives if left untreated. The passage of the Act is certain to have implications for social discrimination issues at some point in the future as well. The National Organization of Fetal Alcohol Syndrome had this to say:

  • President Bush has signed into law the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. The legislation will require insurance companies to place coverage of mental health services and therapeutic alcohol and substance abuse treatment services on par with current medical coverage.
  • For decades, insurers have set higher co-payments and deductibles and stricter limits on treatment for addiction and mental illnesses.
  • Most employers and group health plans provide less coverage for mental health care than for the treatment of physical conditions like cancer, heart disease or broken bones. They will need to adjust their benefits to comply with the new law, which requires equivalence, or parity, in the coverage.
  • By wiping away such restrictions, doctors said, the new law will make it easier for people to obtain treatment for a wide range of conditions, including depression, autism, schizophrenia, eating disorders and alcohol and drug abuse.

Federal officials said the law would improve coverage for 113 million people, including 82 million in employer-sponsored plans that are not subject to state regulation. The effective date, for most health plans, will be Jan. 1, 2010.

So this new Act will be completely integrated into our health care system by 2010. Many people who get new health insurance in 2009 will be affected immediately.

There was a time not long ago that addiction and alcoholism were seen to be indicative of “poor judgement” or “lack of moral character.” The passage of the Mental Health Parity and Addiction Equity Act shows that our health care system and society as a whole is progressively learning the truth – that men and women who suffer from addiction or alcoholism deserve the same rights and medical treatment as people who are afflicted with any other disease or medical problem.

Click here to read more about co-occurring disorders.