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Celebrating a decade of the Parity Act

July 9, 2018
by Ron Manderscheid, PhD, Exec Dir, NACBHDD and NARMH
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In a few short months, on Oct. 3, we will celebrate the 10th anniversary of the enactment of the Mental Health Parity and Addiction Equity Act (hereafter, Parity Act). We all owe a huge debt of gratitude to former Rep. Patrick Kennedy (D-RI), who shepherded this legislation to success. We also owe him even more accolades for the wonderful work he has done since that time through the Kennedy Forum to implement this legislation in practice. 

Conceptually, the Parity Act is quite simple: mental health and substance use health insurance benefits can be no less than medical and surgical benefits, when both types of benefits are offered in a health insurance plan. Yet, the road to implementation has been quite rocky. Federal regulations were long-delayed; their guidance, very complex; and federal enforcement, minimal at best. The principal mechanism for reporting violations has been consumer self-reports, rather than self-assessment by insurance plans, with potential federal audit backup.

Because of these difficulties, President Barack Obama created a Federal Mental Health and Substance Use Parity Task Force that ultimately recommended several key implementation strategies. In addition to consumer self-reporting, the report recommends more stringent state and federal enforcement, together with civil financial penalties for violations.

So, where do we go from here?

This 10th anniversary gives us a wonderful opportunity for great celebration and also the chance to push the reset button on implementation.

First, we have great cause for celebration in October. Parity Act requirements have been incorporated into the State Health Insurance Marketplaces for individual insurance plans, into small group plans, and into the Medicaid expansion, all under the aegis of the Patient Protection and Affordable Care Act. In round terms, this means that the number of persons who have parity protections now is approaching 100 million—a tremendous achievement.

We especially want to celebrate the lives that have been saved because of the Parity Act. Stories abound about persons whose deaths from opioid overdoses were saved by timely intervention, persons who have been saved from suicide attempts because their severe depression was treated, and persons who now are on the road to recovery from serious mental illnesses or serious addiction conditions because of the care that they received. These are both the true successes of the Parity Act and its promise into the future.

Second, we do want to push the resent button on implementation of the Parity Act. Clearly, our goal must be to seek a day in which all Americans will enjoy parity protection, with effective implementation for all who have health insurance coverage.

One critical way of pursuing this work is to establish accreditation certifications and procedures for health insurers. Work on such standards already is underway through the Kennedy Forum, and a new accreditation system should be announced later in 2018.

Thus, we do have much to celebrate on the 10th anniversary of the Parity Act. I hope that you will celebrate with us and help us to pursue universal parity. As Ted Kennedy said, the dream lives on, the work continues, and our hopes will never die.

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Ron Manderscheid

Exec. Dir., NACBHDD and NARMH

Ron Manderscheid



Ron Manderscheid, Ph.D., serves as the Executive Director of the National Association of County...

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