Parity Legislation Stalls

An update on the status of parity legislation:

The differences between the House and Senate negotiators have come down to three main areas: which types of mental illness should be covered, what out-of-network benefits will be offered, and what approach will allow the best preservation of stronger state laws.

Nonetheless, both bills require that insurance plans that include mental health benefits must cover those benefits at parity with in-network or out-of-network medical/surgical benefits. Thus, passage of either the Senate or House version, Meyers said, would constitute a major improvement over the current 1996 Mental Health Parity Act, which only guarantees equality in annual and lifetime payment limits.

One of the main differences over which negotiators remained deadlocked was that the House bill would require any plan that provides mental health parity coverage to recognize all illnesses in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Senate measure would leave it up to health plans to determine the psychiatric conditions they would cover.

Negotiators also were unable to find common ground on differences in out-of-network benefits. The House bill would require any plans that include an out-of-network benefit to also offer out-of-network parity mental health coverage. The Senate version would allow plans to offer a medical/surgical out-of-network benefit without offering a corresponding mental health benefit. If the plans did offer an out-of-network mental health benefit, they would have to do so at parity.