Federal Parity In The Evolving Mental Health And Addiction Care Landscape.
The intent of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 is to eliminate differences between health insurance coverage of mental health and substance use disorder benefits and coverage of medical or surgical benefits. The Affordable Care Act significantly extended the reach of the Wellstone-Domenici law by applying it to new insurance markets. We summarize the evolution of legislative and regulatory actions to bring about federal insurance parity. We also summarize available evidence on how the Wellstone-Domenici law has contributed to addressing insurance discrimination; rectifying market inefficiencies due to adverse selection; and altering utilization, spending, and health outcomes for people with mental health and substance use disorders. In addition, we highlight important gaps in knowledge about how parity has been implemented, describe the groups still lacking parity-level coverage, and make recommendations on steps to improve the likelihood that the Wellstone-Domenici law will fulfill the aims of its architects.
Colleen L. Barry (cbarry@jhu.edu) is a professor in the Department of Health Policy and Management, with a joint appointment in the Department of Mental Health, at the Johns Hopkins Bloomberg School of Public Health, and codirector of the Johns Hopkins Center for Mental Health and Addiction Policy Research, in Baltimore, Maryland.
Colleen L
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Howard H. Goldman is a professor of psychiatry at the University of Maryland School of Medicine, in Baltimore.
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Haiden A. Huskamp is a professor of health care policy at Harvard Medical School, in Boston, Massachusetts.
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Financing Health Care; Health Reform; Insurance; Mental Health/Substance Abuse