The effects of state mental health parity legislation on perceived quality of insurance coverage, perceived access to care, and use of mental health specialty care.
OBJECTIVE
To assess the impacts of recent state mental health parity legislation on perceived quality of health insurance coverage, perceived access to needed health care, and use of mental health specialty services by individuals with likely need for mental health care.


METHODS
The study sample came from two waves of a national household survey first fielded in 1997-1998 and then in 2000-2001. The analysis used a subset of the sample.


METHODS
The study took the Difference-in-Difference-in-Difference approach to investigate changes in self-perceived quality of health insurance coverage and access to needed health care, and use of mental health specialty care by the group with mental disorders (relative to those without) in states with parity legislation of different comprehensiveness (relative to the nonparity states) in the years after the law (relative to before the law).


RESULTS
Overall, there were no significant or consistent effects of the parity legislation. Descriptive statistics showed significant changes in some (but not all) outcome variables, but these results disappeared in detailed statistical analyses by controlling for important covariates.


CONCLUSIONS
The null findings of the effects of state mental health parity mandates suggest that under ERISA (Employee Retirement Income Security Act), the scope of state parity legislation may have been restricted because of large proportion of self-insured employers. Furthermore, comprehensiveness of state legislation appears to be related to the traditional level of use of mental health specialty care, which becomes another confounder for the potential policy effects.
Bao
Yuhua
Y
Center for Community Partnerships in Health Promotion, Department of Medicine/General Internal Medicine, UCLA, 1100 Glendon Ave., Suite 2010, Los Angeles, CA 90024, USA.
Sturm
Roland
R
D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D008605:Mental Health Services / Q000191:economics* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D015233:Models, Statistical; D012044:Regression Analysis; D014481:United States