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Parity Laws Curb Bias Against Mental Illness When Enforced

United Healthcare to improve access to mental health care following settlement.

Key points

  • Individuals with mental illness often face illegal roadblocks when seeking coverage of and/or reimbursement for vital services and treatment.
  • Those affected must often serve as their own advocates, educating themselves on such issues as insurance companies’ legal responsibilities.
  • Rigorous enforcement of parity laws removes burden from individuals and families already coping with realities of mental health diagnoses.
Thomas Andre Fure/Shutterstock
Source: Thomas Andre Fure/Shutterstock

In mid-August, UnitedHealthcare – the nation’s largest health insurer – resolved allegations that it denied coverage or reduced the reimbursement of consumers’ mental health and substance abuse benefits in the State of New York. The company’s actions were illegal under New York’s behavioral health parity law, which along with the federal Mental Health Parity and Addiction Equity Act, requires insurance coverage for mental health and substance use disorder treatment to be “no more restrictive” than coverage for physical health conditions.

This settlement illustrates a distressing reality in our society and across the healthcare system. Despite the emphasis on psychological wellness and self-care, persistent bias against mental health, especially compared with physical ailments and limitations, add challenges to individuals and families coping with mental health diagnoses.

I see this everyday in my mental health law practice. Family members share how their loved ones with serious mental health conditions regularly face roadblocks when seeking coverage of and/or reimbursement for vital services. Much of the financial burden for out-of-pocket treatment ultimately falls on these families who don’t necessarily have the means to pay.

With such stories, it’s no wonder that close to half of all Americans with mental illness are not getting needed help, as Mental Illness Policy Org estimates.

To combat the system’s bias, individuals and family members coping with mental health diagnoses must often be prepared to serve as their own advocates, educating themselves on such issues as insurance companies’ legal responsibilities and avenues for response if they’re inappropriately denied coverage. For example, consumers have the right to appeal an insurance company’s decision and have it reviewed by an independent party. In urgent cases, insurers are tasked with expediting this process.

Of course, such efforts are time-intensive, and loved ones of individuals affected by mental illness often serve as caregivers for them, which can drain both individuals’ and family members’ capacity for advocacy.

This points to the need for rigorous enforcement of parity laws. I salute New York Attorney General Letitia James who pursued a settlement with UnitedHealthcare in the face of other pressing societal issues and sought commitments that the insurer would remove barriers to mental health treatment. More actions like these will motivate insurance companies to ensure its members with mental health conditions benefit from the same access to treatment as those with physical health needs.

Combatting our society’s bias against mental illness requires a variety of measures from myriad parties and spaces. This includes fighting for the rights afforded under state and federal parity laws, which trailblazers worked tirelessly to get on the books.

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