« June 2015 Issue
Engaging State Partners to Promote Behavioral Health Equity
Health insurance coverage for drug and alcohol problems and for mental illness has long been treated as an afterthought, offered with skimpy benefits, if any at all. In 2008, Congress passed the Mental Health Parity and Addiction Equity Act (parity law) that was designed to end discriminatory practices against people with these health issues by requiring equity in benefits for physical and behavioral health. The Affordable Care Act extended the parity law's reach, so that the law covers most small group and individual private insurance plans as well as Medicaid managed care and the Children's Health Insurance Program (CHIP).
Even so, consumers more often than not still faced an uphill battle in successfully accessing behavioral health benefits, if they were even offered in their coverage. The need for additional enforcement on behalf of consumers was apparent, and Community Catalyst has spent years working with other organizations advocating for federal regulations to spell out how the law should be implemented and enforced.
In April, seven years after passage of the parity law, the Centers for Medicare and Medicaid Services (CMS) unveiled proposed regulations that spell out how the law will be applied to an estimated 22 million children and adults enrolled in the Medicaid and CHIP programs.
"Finally, there will be a regulatory framework in place to protect consumers," said Meredith Munn, state advocacy manager for Community Catalyst's Substance Use Disorders team.
Following the announcement, the Community Catalyst Substance Use Disorders team sprang into action to ensure consumers let CMS know what's good in the regulations and what needs strengthening.
The team is working closely with Health Law Advocates, a Massachusetts-based public interest law firm, in crafting and submitting comments to CMS emphasizing the critical importance of strong behavioral health parity for Medicaid and CHIP beneficiaries. At the same time, the team is distributing template comments to state advocates that will allow them to weigh in and to share consumer stories with CMS about barriers consumers face in getting treatment.
This combined effort, raising national and state voices together, aims to advance Community Catalyst’s goal of ensuring consumers get the health care they need, whether that health care is for their minds or their bodies.
"Strong parity regulations will build a base for stronger parity enforcement," said Alice Dembner, project director for Substance Use Disorders. "We are also helping state advocates understand how to assist consumers with complaints and appeals, and how to encourage state officials to hold health plans responsible."
By engaging existing coalitions, providing policy guidance, developing resources for advocates and spurring action, the substance use disorders team is also setting the stage for broader improvements. Those improvements include more widespread prevention of substance use disorders, as well as more comprehensive treatment and recovery services. The team and its state partners are also advocating for integrating the treatment of behavioral health with physical health, which can improve consumers' health as well as reduce long term health care costs.
Jack Cardinal, Communications Manager