Kaine & Warren Reintroduce Bill to Help Americans Access Mental Health Coverage
WASHINGTON, D.C. — Today, U.S. Senator Tim Kaine joined Senator Elizabeth Warren in reintroducing the Behavioral Health Coverage Transparency Act, legislation that would strengthen oversight and enforcement of federal parity laws requiring that most insurance plans provide mental health coverage on par with the coverage they provide for other medical or surgical services. This bill would help hold health insurers accountable by ensuring they provide adequate behavioral health care benefits as part of health care coverage plans and increase transparency for consumers seeking coverage for mental health and substance use disorders.
“The past few years have been challenging on us all, and it’s underscored the need to improve access to mental health care services,” said Senator Kaine. “This legislation is a necessary step to improving transparency, protecting consumers, and helping more Americans access mental health and substance use disorder treatment.”
In 2008, Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA), which limited higher copayments, separate deductibles, and stricter preauthorization or medical necessity reviews for behavioral health services as compared to other medical and surgical services.
Congress took a next step toward addressing the concern of mental health parity in the Consolidated Appropriations Act of 2021 (CAA), granting the Department of Health and Human Services (HHS), Department of Labor (DOL), and Treasury Department increased oversight authorities to help provide insight into insurers’ compliance with federal parity laws. In February 2022, the Departments issued their first report following the implementation of these new provisions and documented significant gaps in compliance, confirming that more needs to be done to strengthen enforcement and protect consumers.
The updated legislation, which builds on the provisions passed in the CAA, would:
- Increase transparency by requiring insurance plans and third-party administrators to submit annual reports with information on any non-quantitative treatment limitations and to disclose additional data on denial rates, reimbursement rates, and network adequacy;
- Encourage compliance by ensuring that HHS, DOL, and Treasury conduct a review of no fewer than 100 plans per year, including 40 randomized audits;
- Establish a toll-free telephone number and an online Consumer Parity Portal to offer patients and providers a centralized website hosting information on patients’ rights, findings from oversight efforts, and resources to ensure that health care consumers receive the protections they are guaranteed by law; and
- Support consumers by encouraging collaboration across federal agencies and with states, including by awarding grants to establish, expand, or provide support for offices of health insurance consumer assistance and health insurance ombudsman programs.
This legislation is cosponsored by Senators Tammy Baldwin (D-WI), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Sherrod Brown (D-OH), Amy Klobuchar (D-MN), Ben Ray Luján (D-NM), Ed Markey (D-MA), Chris Murphy (D-CT), Bernie Sanders (I-VT), Tina Smith (D-MN), Debbie Stabenow (D-MI), and Chris Van Hollen (D-MD).
The bill is supported by over 50 advocacy organizations, including: The American Psychiatric Association, Community Catalyst, National Alliance on Mental Illness, The Kennedy Forum, Legal Action Center, 2020 Mom, American Academy of Addiction Psychiatry, American Academy of Social Work and Social Welfare, American Association for Psychoanalysis in Clinical Social Work, American Association on Health and Disability, American Foundation for Suicide Prevention, American Group Psychotherapy Association, American Occupational Therapy Association, American Psychoanalytic Association, American Psychological Association, American Society of Addiction Medicine, Anxiety & Depression Association of America, Association for Ambulatory Behavioral Healthcare, Bazelon Center for Mental Health Law, Campaign for Trauma Informed Policy and Practice, Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD), Clinical Social Work Association, College of Psychiatrists and Neurologic Pharmacists, Depression and Bipolar Support Alliance, Eating Disorder Coalition, Global Alliance for Behavioral Health and Social Justice, Jewish Federations of North America, Inseparable, International OCD Foundation, International Society for Psychiatric Mental Health Nurses, Lakeshore Foundation, Maternal Mental Health Leadership Alliance, Mental Health America, NAADAC, the Association for Addiction Professionals, National Alliance to Advance Adolescent Health, National Association for Behavioral Healthcare, National Association for Children's Behavioral Health, National Association of Addiction Treatment Providers, National Association of Pediatric Nurse Practitioners, National Association of Social Workers, National Association of State Mental Health Program Directors, National Eating Disorders Association, National Federation of Families, National Health Care for the Homeless Council, National League for Nursing, NHMH - No Health without Mental Health, Partnership to End Addiction, REDC Consortium, RI International, School Social Work, Association of America, and SMART Recovery.
Full text of the bill is available here. A full summary is available here.