Parity passes

Parity finally passed both branches of congress and was signed into law by the President.

This is a good and important step. Health Affairs explains what this means, what will happen next and what still needs to happen:

A thoughtful essay by Audrey Burnam and José Escarce in an earlier volume of Health Affairs contends that the debates around parity in insurance benefits are the latest manifestations of a longer-standing policy issue regarding equity of mental health care relative to general medical care. These authors argue that in an era of managed care, benefit parity is an insufficient mechanism for ensuring equity for those with a mental illness.26 Put another way, full benefit parity is an important “sequential” step toward the broader goal of ensuring that persons with a mental illness or addiction have the same opportunities for seeking and receiving appropriate treatment as those with a physical illness.

Importantly, a sequential approach to promoting treatment equity implies a recognition that full parity resolves some, but far from all, obstacles to access and use of appropriate services among persons with mental and addictive disorders. On the supply side, full parity generally indicates a nominal expansion of benefits. However, parity also has yielded increased management of care, and such management can be differentially applied in ways that produce unequal treatment opportunities (through either initial access or intensity and/or duration of services) for those with psychiatric versus general medical conditions. On the demand side, full parity results in the removal of arbitrary and inequitable limits to treatment. However, removal of these limits under parity may have little effect on the concomitant stigma that keeps many who need mental health and substance abuse services from seeking such care. In short, legislating full parity will promote, but not achieve, treatment equity for those with mental and addictive disorders. Nevertheless, without such action, the goal of equity will continue to remain elusive.