January 25, 2018

Kaine Introduces Bill To Hold Insurance Companies Accountable For Adequate Mental Health Coverage

WASHINGTON, D.C. – U.S. Senator Tim Kaine (D-VA) joined Senator Elizabeth Warren (D-MA) and 18 of their colleagues to introduce the Behavioral Health Coverage Transparency Act, which will hold health insurers accountable by ensuring they provide adequate mental health benefits as a part of health care coverage plans and increase transparency for consumers seeking coverage for mental illness and substance use disorders. Under current federal law, most insurance plans must provide mental health coverage on par with the coverage they provide for other medical or surgical services, a requirement known as "parity." However, adherence to existing parity laws has been weak and inconsistent.

“This bill is an effort to ensure that Americans receive the appropriate health care coverage for physical and mental illnesses that they are guaranteed by law,” Kaine said. “It’s important to keep insurance providers accountable and improve transparency so we can protect and empower patients in Virginia and across the country.”

Kaine has worked to expand access to mental health services, particularly for rural Virginians. Last year, Kaine introduced the Medicare-X Choice Act to create a public plan that would offer families, individuals, and small businesses additional, low-cost health insurance choices and guarantee essential health benefits established in the Affordable Care Act, such as mental health services.

According to a National Alliance on Mental Illness report, insurers denied patients authorization for mental health care at nearly twice the rate they did for medical care, often providing no information about the criteria used to make the decision. A follow-up survey found that over a third of respondents covered by private insurance struggled to find a single mental health therapist who would accept their insurance.

The Behavioral Health Coverage Transparency Act would require insurance issuers to disclose annually to federal regulators the analysis they perform in making parity determinations as well as the rates and reasons for mental health claims denials versus medical/surgical denials. It also would require the Department of Health & Human Services, the Department of Labor and the Department of Treasury to undertake a minimum of 12 random audits of health plans per year to discourage noncompliance with existing parity laws. Finally, it would establish a Patient Parity Portal, allowing consumers to easily access all publicly available parity information and submit complaints in a central online clearinghouse.

The Behavioral Health Coverage Transparency Act, introduced by U.S. Senator Elizabeth Warren (D-MA), is also cosponsored by U.S. Senators Sherrod Brown (D-OH), Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Tina Smith (D-MN), Edward Markey (D-MA), Cory Booker (D-NJ), Kamala D. Harris (D-CA), Maggie Hassan (D-NH), Chris Murphy (D-CT), Bernie Sanders (I-VT), Debbie Stabenow (D-MI), and U.S. Representatives Doris Matsui (D-CA), Paul Tonko (D-NY), Ben Ray Lujan (D-NM), Eliot Engel (D-NY), Congresswoman Jan Schakowsky (D-IL), Bobby Rush (D-IL), and Debbie Dingell (D-MI).

The legislation has received support from the following advocacy and expert organizations: American Association of Child & Adolescent Psychiatry, American Foundation for Suicide Prevention, American Psychiatric Association, American Psychological Association, American Society of Addiction Medicine, Community Catalyst, Depression and Bipolar Support Alliance, Eating Disorders Coalition, Facing Addiction, Hazelden Betty Ford Foundation, Mental Health America, Massachusetts Medical Society, National Alliance on Mental Illness, National Association of Addiction Treatment Providers, National Association of State Mental Health Program Directors, National Council for Behavioral Health, National Federation of Families for Children's Mental Health, Parity Implementation Coalition, Residential Eating Disorders Consortium, Young People in Recovery, Watershed Addiction Treatment Programs.

###