The AMA and The Kennedy Forum have launched an interactive mapping tool to expose how well commercial insurance plans comply with mental health parity laws. The Mental Health Parity Index, developed collaboratively with Third Horizon, analyzes plans based on access, coverage, and payment for mental health and substance-use services compared with physical health services using publicly available transparency data.
Piloted in Illinois, the index reveals stark disparities. According to the data, there is a 55% difference between the percentage of physicians and health professionals providing physical health services compared with those treating mental health and substance-use disorders. Additionally, there is a nearly 27% difference in payment to physicians providing physical health services compared with those delivering mental health and substance-use disorder care. Per day payment for inpatient mental health admissions is on average almost twice as much as physical health admissions.
The Mental Health Parity and Addiction Equity Act of 2008 requires insurers to offer coverage for mental health and addiction treatment on par with other medical and surgical care. However, the AMA has documented multiple violations including excluding therapy for autism spectrum disorder and cognitive or rehabilitative interventions for mental health or substance-use disorders, and excluding medication-assisted treatment for opioid-use disorder. Commercial insurers have forced more than 156 million Americans to seek out-of-network providers for mental health services, according to The Kennedy Forum.
At the Illinois rollout event in May, Dr. Jesse M. Ehrenfeld, then the AMA’s immediate past president, stated that when people struggling with mental health seek help, they should be able to access and afford timely and appropriate care—yet too often, health plans prevent this. The AMA continues to urge state and federal policymakers to hold health plans accountable, as failures to comply mean patients are not receiving medically necessary care recommended by their physicians, likely leading to disruptions in care and patient harm.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.ama-assn.org/public-health/behavioral-health/new-tool-brings-mental-health-parity-problems-light