Better Parity Act Enforcement Needed to Protect People with Addiction
One of the major problems of today’s deadly opioid epidemic and persistent addiction crisis is lack of access to effective treatment. One of the major reasons people are unable to get treatment is the apparent lack of coverage by their health insurance plan. This continues to happen despite the Mental Health Parity and Addiction Equity Act of 2008 (Parity Act), a federal law that requires equitable insurance coverage for addiction treatment by most health plans.
To investigate this issue further, we collaborated with the Legal Action Center, Partnership for Drug-Free Kids and Treatment Research Institute to conduct an in-depth analysis of publicly available documents for seven major health plans offered in 2015 and 2016 in the small and large group insurance markets in New York and Maryland. Both New York and Maryland have been leaders in parity enforcement.
The analysis, released today, raises serious doubts about whether the current enforcement framework is adequate to protect the rights afforded to consumers under the Parity Act. The key finding of our research is that both regulators and the public lack sufficient information to determine parity compliance or report violations.
We also found that critical details about coverage and access to treatment are often missing from insurance plan documents. There was also no information for people to understand their rights under this law. It would be a challenge – if not impossible – for an average person to know whether their insurance plan violates the Parity Act.
The current enforcement system relies on people to report problems with parity to insurance regulators. When the regulators don’t receive complaints, they assume the plans are in compliance. This analysis reveals that most parity violations cannot be identified through consumer complaints nor can they be identified through the current regulatory approval process.
Help Enforce Parity
We need to shift away from this approach and ensure that health insurance plans are demonstrating compliance BEFORE they are marketed to consumers. Regulators, such as government agencies that oversee insurance, can and should demand this information. In order to document the challenges that consumers have in accessing addiction treatment coverage and call for a complete change in the enforcement framework, we are encouraging parents and families to sign a petition to help enforce the Parity Act. You can also find more details about the findings of the report in our executive summary.
The Addiction Solutions Campaign
This project was the first collaboration between our Center, the Legal Action Center, Partnership for Drug-Free Kids and Treatment Research Institute, as part of our newly formed Addiction Solutions Campaign (ASC). The ASC aims to increase public access to practical, effective services, tools, and policies to prevent, treat, and support long-term recovery from substance use disorders.
Lindsey Vuolo, JD, MPH
Lindsey is Associate Director of Health Law and Policy at Center on Addiction