MENTAL-health parity sounds great on paper. Passed by the state Legislature in 2005 and U.S. Congress in 2008, laws require health-insurance companies to cover mental-health care on par with physical-health care. The Affordable Care Act further stiffened that mandate.
But parity has too often been an empty promise.
Insurers have continued to impose restrictions on therapy visits, to deny types of evidence-based interventions and to gum up claims with extensive demands for prior authorization.
New York's attorney general settled three parity cases in the past year against insurers, including a $31 million settlement against EmblemHealth for denying mental-health claims at a rate two-thirds higher than physical-health claims. In California, denials for mental-health claims were overtuned at the appeals level at a significantly higher rate than for physical-health claims.
Prescription:
Insurance Commissioner Mike Kreidler should push insurers to live up to the mental health parity law, and pursue enforcement against companies who fail. He should also use the existing law to compile and release insurance appeals.
There is no data available in Washington because Insurance Commissioner Mike Kreidler hasn't compiled it. Nor has his office pursued a single mental-health parity case in the nine years since the state law took effect. Kreidler, who finally issued clarifying rules on the state parity law last month, acknowledges that "not all insurers treat it like other carriers."
Mental-health providers such as Lauren Harris, a Shoreline therapist, already know that. She recently complained to Kreidler's office about an insurer's restrictions on visits for a client who has severe anxiety and depression. "I thought parity is what it meant. But it isn't," she said.