LISTEN: The Biden Administration is imposing a new rule to better clarify and enforce the Mental Health Parity and Addiction Equity Act of 2008. The language closely mirrors standards set by Georgia lawmakers in 2020. GPB’s Ellen Eldridge reports.

Mental Health Parity Act

Gov. Brian Kemp (right) shakes the hand of late House Speaker David Ralston after signing House Bill 1013, the Mental Health Parity Act, into law in 2022. In July 2023, the White House added rules tightening a 2008 federal law similar to the Georgia act.

Credit: Riley Bunch / GPB News

Rates of mental illness and substance use disorder have been increasing nationwide since the COVID-19 pandemic, but people have difficulty finding treatment for behavioral health care because it's not covered by insurance.

In 2008, Congress passed the Mental Health Parity and Addiction Equity Act, which requires commercial health plans to provide benefits covering behavioral health care treatment in a manner that is “no more restrictive” than that used for all other medical/surgical services.

However, the law failed to increase access to treatment and decrease the cost of mental health care. Enforcement of MHPAEA is influenced by insurance office relationships, legal interpretation and political priorities, a recent study shows.

Updates over recent years in language associated with the 2008 law reflect how lawmakers across the political spectrum are increasingly, and more personally, affected by mental illness and substance use disorder.

Georgia made mental health parity a priority with House Bill 1013, sponsored by the late former House Speaker David Ralston.

“This is an issue that's not Republican or Democrat,” Ralston said on Political Rewind shortly before announcing the bill. “It's not urban, rural or suburban. It's not Black or white. It's not rich or poor. I mean, this cuts across every strata of our society here in Georgia and everywhere. And it's also an issue I feel very passionate about.”

President Joe Biden on July 25 announced a federal rule with similar language to HB 1013 meant to strengthen mental and physical health parity requirements and improve mental health care access nationwide.

Of the 21% of adults who had any mental illness in 2020, less than half received mental health care, the White House said in its statement; fewer than 1 in 10 with a substance use disorder received treatment.

Someone with a serious mental illness has a 1 in 5 chance of ending up in prison instead of a hospital, according to Mental Health America of Georgia, and the state continues to rank at the bottom of the nation for access to behavioral health care, but the framework is in place.

Gov. Brian Kemp signed the Mental Health Parity Act to clarify language in the 2008 federal law and allow for better enforcement of parity for physical and mental health needs.

Similarly, Biden's rule requires health plans to evaluate their coverage for compliance, set out-of-network payments, and it closes a coverage loophole in the original act for state and local governments, Christen Linke Young, the special assistant to the president for health and veteran affairs, said.

"Today's rule codifies changes to that law and makes it clear that state and local government health plans, just like all other employer health plans, have to be in compliance and they have to provide adequate mental health benefits that are really at parity with the physical health benefits they provide," Linke Young said.

She added that preventing a mental health crisis with good care ultimately saves lives and money.