A young woman sits on a couch together with her therapist.
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The Biden administration plans to crack down on medical health insurance plans that discriminate against individuals who need mental health care and substance abuse treatments.
A proposed rule published Tuesday by the Health and Human Services, Labor and Treasury departments goals to push health insurers to comply with the Mental Health Parity and Addiction Equity Act.
That law, which was passed in 2008, requires insurance policy that cover mental health care and substance abuse treatments to supply the identical level of coverage for these services as they do for other illnesses.
White House domestic policy advisor Neera Tanden told reporters in a call Monday that too many insurers are evading the law and making it difficult for patients to access mental health care.
Insurance policy often don’t provide enough therapists in network, which forces patients to hunt care out of network and pay more. Patients also often should get permission from their insurer to hunt treatment or have their claims denied leaving them with the bill.
“This has meant thousands and thousands of people that have insurance are paying out of pocket once they shouldn’t should,” Tanden said.
A couple of in five adults within the U.S., or 58 million people, live with a mental illness, in keeping with the National Institute of Mental Health.
The proposed rule would require insurance policy to judge how their coverage policies impact patients’ access to mental health and substance abuse treatments, Tanden said.
Insurers can be required to take motion in the event that they should not in compliance with the law, she said. This might include adding more therapists to the insurance network if patients are looking for care out of network too often, Tanden said.
The proposed rule will undergo a 60-day public comment period before it’s finalized.
A survey published in July of nearly 2,800 patients found that folks with insurance face more challenges accessing mental health services than other forms of medical care.
Nearly 40% of individuals enrolled in insurance through their employer needed to seek more costly mental health care or substance abuse treatment out of network, in keeping with the survey conducted by the research institute NORC. By comparison, 15% of individuals looking for physical health care went out of network.
Greater than 50% of patients reported that their insurance denied coverage three or more times for mental health or substance abuse services, in comparison with 33% who reported the identical for physical health care.
And nearly 60% of those surveyed who sought mental health care or substance abuse treatment didn’t receive any care in at the least one instance.