NAMI Releases Parity Report Which Finds Insurance Companies Still Discriminate Against Mental Health Care

Nov 30 2017

Arlington, Va. November 29, 2017-- A report released today by NAMI reveals new information about the ongoing barriers people with mental illness experience when trying to find affordable, quality mental health care. 

The Doctor is Out: Continuing Disparities Between Mental and Physical Health Providers in Health Insurance highlights inequities between health insurance coverage of mental health and substance abuse conditions and that of other medical conditions. Specifically, it looks at the shortages of in-network mental health care providers and disproportionate out-of-pocket costs for people seeking mental health care.

The Mental Health Parity and Addictions Equality Act, the federal law signed by President Bush in 2008, requires parity in health insurance coverage of mental health and physical health benefits, yet the report finds that gaps remain for patients seeking quality, affordable mental health coverage.

“This report once again confirms a painful reality for millions of adults and children living with mental health conditions: that despite passage of a federal health parity law, discrimination is still rampant,” said Mary Giliberti, CEO of NAMI. “In contrast to people seeking health care for conditions like heart disease or diabetes who have access to specialists and facilities within their networks, people living with mental illness simply don’t have the same access to care.”

The report is based on a nationwide online survey, conducted in 2016, of 3,177 individuals with mental health conditions and mental health caregivers. Survey respondents had coverage from either private health insurance or public health coverage such as Medicaid or Medicare.

Key findings of the report include:

  • Searching for a provider: Nearly 35% of respondents with private insurances reported difficulties finding any mental health therapist who would accept their insurance.
  • Out-of-network care: 28% of respondents who received psychotherapy used an out-of-network provider. In contrast, only 7% of respondents used an out-of-network medical specialist and only 3% used an out-of-network primary care provider.
  • Out-of-pocket costs: Out-of-pocket costs exceeding $200 were over 1.5 times more frequent for mental health therapists (15%) and psychiatric prescribers (16%) compared to medical specialty care (9%).

The report also includes policy recommendations developed by NAMI to address the issue, including:

  • Conduct federal and state-level parity compliance market audits of health plans. 
  • Improve network adequacy for mental health care through the following:
    • Increase reimbursement rates and other incentives for mental health professionals;
    • Increase reimbursement and reduce barriers for tele-mental health services;
    • Expand reimbursement for models that integrate health, mental health and substance use disorder care; and
    • Recruit and contract with a wider range of providers; and
    • Promote use of advance practice nurses and other health care professionals with appropriate training to prescribe mental health medications. 

The NAMI report was released simultaneously with a report published by Milliman, Inc. on behalf of a coalition of America’s leading mental health and addictions advocacy organizations. The Milliman report uses private health insurance data that validates what NAMI’s surveys have shown: people must seek mental health care out-of-network much more frequently than for other health care. It also proves that psychiatrists are routinely paid less than primary care doctors and medical specialists for the same types of services – even those under the same billing codes.

To learn more and read NAMI’s report, visit www.nami.org/parityreport. To read the Milliman report, visit www.milliman.com