Mental Health Parity at Risk | NAMI: National Alliance on Mental Illness

Posted on June 12, 2018

[Arlington, VA]—Today, NAMI released a report highlighting the impossible barriers millions of Americans living with mental health and substance use disorders faced prior to passage of the Affordable Care Act (ACA).  These findings underscore how current efforts to weaken the individual insurance market could mean returning to a time when Americans with mental health conditions could be denied coverage or offered coverage that excludes services they need.  

This report, written by researchers at Georgetown University, highlights the damaging impact a return to pre-ACA practices would have on people who need mental health and substance use services. For the first time, we have comprehensive data showing barriers and gaps in mental health and substance use coverage in the individual market prior to the ACA.  

“As a country, we must put our health first, and that includes both mental and physical well-being. There is no health without mental health and there should be no health insurance without mental health coverage,” said Mary Giliberti, CEO of NAMI. “We need the Administration to retain policies that prioritize people over profits. Cutting lifesaving treatments and health coverage for people with mental illness as a cost-saving measure should never be an option.”

NAMI’s new report, Mental Health Parity at Risk, looks at the barriers and gaps in mental health and substance use coverage in the individual health insurance market prior to the ACA and finds:

  • Twenty-eight states did not require individual market insurance plans to cover or even offer mental health services;
  • Insurers routinely denied coverage to people with preexisting mental or substance use conditions by screening applicants and offering coverage that excluded the services they needed;
  • Insurers penalized people with a history of mental health or substance use conditions by imposing a 20, or even 50, percent increase in premiums;
  • Insurers offered superficial coverage that did not meet needs by imposing limitations like lifetime caps, limits on outpatient visits, limits on inpatient days covered and exclusions of mental health medications; and
  • Insurers actively created barriers and limited access for people trying to get mental health and substance use treatment through aggressive cost-sharing and lengthy prior authorization procedures.

"We know the individual market for health insurance failed people with mental health and substance use service needs before the ACA required plans to cover these services" said Dania Palanker, Assistant Research Professor at Georgetown University's Health Policy Institute. "It's deeply concerning that the Administration is encouraging a return to a market without mental health and substance use protections by expanding subpar coverage such as short-term and association health plans."

Before the ACA, individual insurance plans routinely failed to meet even the most basic needs of Americans with mental health and substance use conditions. NAMI does not support a return to policies that discriminate against people with preexisting conditions, allow benefit limitations on mental health and substance use treatment coverage or promote disparities in insurance coverage. NAMI calls on the Administration to act in the best interest of people with mental health and substance use disorders and protect them from discriminatory actions by insurance companies. 

The report, as well as additional facts and information, is available at Parity at Risk

About NAMI

NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to improving the lives of individuals and families affected by mental illness. 
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