The new federal mental parity law seems to be having a noticeable effect on employers’ health plan designs.
John Dicken, a director at the U.S. Government Accountability Office (GAO), writes about the early impact of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) in an MHPAEA report prepared for several House and Senate committees.
MHPAEA replaces an earlier mental health parity law enacted in 1996.
Neither law requires an employer to offer mental health or substance abuse benefits. Both laws affect only employers that choose to offer behavioral health benefits along with other medical benefits.
The 1996 law required any mental health and other medical benefits offered to be similar.
The new law imposes more detailed parity rules, extends the parity rules to substance abuse problems, and calls for plans that violate the MHPAEA parity requirements to pay fines of up to $100 per enrollee per day.
GAO investigators tried to look at the early effects of the new law by conducting an employer survey. The investigators sent out 700 survey forms and collected just 168 usable responses.
The survey results do not necessarily represent how all employers are doing, but they provide some information about what is happening at the participating employers, Dicken says.
Although health insurance costs have been climbing and the MHPAEA does not require employers to offer behavioral health benefits, 96% of the employers participating in the GAO survey offer behavioral health benefits, the same as in 2008.
Only 2% of the employers said they offer coverage for mental health conditions but not for substance use disorders, and that percentage was the same as in 2008.
Only 7% of the responding employers said they still impose limits on the number of allowed office visits for mental health conditions, down from 35% in 2008.
The percentage of responding employers that impose limits on the number of allowed inpatient days for mental health treatment fell to 9%, from 29%.
The percentage with limits on substance abuse treatment office visits fell to 8%, from 33%, and the percentage with limits on inpatient substance abuse treatment days fell to 8%, from 27%.
The percentage with lifetime dollar limits on coverage for behavioral health problems fell to 5%, from 20%.
“Employers that reported lifetime dollar limits on mental health treatments for the current plan year generally told us that these limits applied to all treatments for [behavioral health problems] or that they applied to all treatments covered by the plan—including both [behavioral health problems] and medical/surgical,” Dicken says.