Our View: New rules improve coverage for mental health care

The Affordable Care Act has been getting plenty of headlines in the past few weeks — many of them negative, and deservedly so. Although some states, including Minnesota, have viable insurance exchanges up and running, the launch of the federal system has been little short of disastrous.

But last week, something very important happened in the area of health care. It didn't make many front pages or big headlines on websites, but this development has the potential to profoundly affect the lives of millions of Americans.

On Friday, the Obama administration announced the final rules to implement the Mental Health Parity and Addiction Equity Act. In so doing, it put teeth into a law, passed in 2008, that "requires parity between mental health or substance use disorder benefits and medical/surgical benefits with respect to financial requirements and treatment limitations under group health plans and group and individual health insurance coverage."

This is a law that has Minnesota's fingerprints all over it. Sen. Paul Wellstone championed this cause, and his son, David, picked up the torch after his father's death in a plane crash in 2002. Rep. Jim Ramstad, who represented Minnesota's 3rd District for nearly two decades before retiring in 2009, was a tireless advocate for the mentally ill and played a key role in getting mental health parity legislation through the U.S. House. If Ramstad has a legacy (and we're convinced he does), then it's the Mental Health Parity Act.

The problem was the 2008 act signed by President George W. Bush was relatively toothless. Insurance companies found and exploited loopholes that for many patients resulted in higher costs, spending caps and limited access to psychiatric care and medication.


In short, we haven't fully escaped the idea that mental illness is somehow less significant than cancer, diabetes and heart disease. Those who suffer from depression, schizophrenia, bipolar disorder and countless other mental health conditions are still being stigmatized and penalized.

On Friday, Health and Human Services Secretary Kathleen Sebelius acknowledged that problem but said the tide is about to turn. "For way too long, the health-care system has openly discriminated against Americans with behavioral health problems. We are finally closing these gaps in coverage."

The specifics of the new rules are complex, but essentially, they guarantee that if you have insurance that covers mental health care and substance abuse disorders, then your co-pays, deductibles and other limits on that care will be similar to the coverage you have for hospitalization, surgery and outpatient medical treatment.

Of course, there are some caveats, with the biggest one being that the new rule doesn't force every insurance company to cover mental health care. Exempt from the law are non-federal governmental plans that have 100 or fewer employees, as well as small, private employers who have 50 or fewer employers on their health plans. That means real "mental health parity" won't be a reality for millions of Americans who are battling an illness that can't be diagnosed through blood tests or an MRI.

That's the bad news. The good news is that today, an estimated 62 million Americans have better access to mental health care than they did last week. For many, this care will make them better parents. Better employees. Better students. Better spouses. Happier people, with hope for the future.

As legacies go, this one will be tough to beat.

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