Scientists Say Parity Law Did This to U.S. Addiction Treatment Costs

A key federal health law seems to have pumped up U.S. spending on outpatient treatment of substance abuse without doing much to increase spending on outpatient mental health care.

A team of scientists led by Norah Mulvaney-Day has published data supporting that conclusion in an analysis of the effects of the the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

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A policy office at the U.S. Department of Health and Human Services (HHS) hired the team to assess the impact of the MHPAEA on outpatient care spending in the large-group insurance market.

The law does not require any plan to offer mental health or addiction treatment benefits.

If, however, a plan does offer such benefits, it must provide behavioral services coverage that’s comparable to the coverage for other types of health problems, such as heart disease, or liver disease. The plan cannot impose tighter quantitative coverage limits, such as higher deductibles. The plan also cannot impose tougher non-quantitative treatment limits, such as tougher utilization review programs.

The regulations needed to implement the MHPAEA parity requirements took effect in 2011.

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The Mulvaney-Day team found that the MHPAEA had little or no effect on the percentage of enrollees who sought outpatient mental health or addiction treatment services.

The parity law had only a small effect on the amount of services used by enrollees who sought mental health average. For those enrollee, the team says, the average number of outpatient services per month increased to about 2.8 in 2015, from about 2.1 in 2005.

The MHPAEA had a much bigger effect on use of outpatient care by people with problems with substance abuse.

For those enrollees, the average number of outpatient services per month increased to about 6.5 in 2015, from about 4.1 in 2005.