Getting people the behavioral health care they need
Earlier this year, a federal judge ruled in favor of more than 50,000 patients who brought a class action lawsuit against UnitedHealth Group, the nation’s largest health insurer, for unfairly denying their claims for mental health and substance use disorder treatment. In his ruling, the judge blasted UnitedHealth for cutting costs at patients’ expense and preventing them from getting recommended treatment unless their behavioral health issue was an emergency.
This ruling was an important victory for patients and behavioral health advocates, but patients shouldn’t be forced to join a years-long class action suit against their insurance company just to get the treatment they need. We must guarantee health coverage for every American, and we also should fight to ensure that no person faces illegal discrimination when seeking behavioral health care.
Congress banned discrimination like this in 2008, when it passed the Mental Health Parity and Addiction Equity Act to require insurance companies to adhere to the same standards of coverage for behavioral health as for other health conditions.
This bipartisan law has been on the books for over 10 years, but weak oversight and little real recourse for patients has allowed insurance companies to get away with illegal discrimination.
One in 5 American adults struggles with a mental health condition, but less than half of the 46.6 million who require treatment actually get it.
Experts point to a number of reasons to explain why people don’t get the treatment they need, including the unfounded, outdated stigma around seeking help. But many Americans simply can’t afford or access treatment.
Even for those who have health insurance, behavioral health care is often inaccessible or prohibitively expensive. It doesn’t help that insurance companies routinely deny mental health and addiction claims, as we saw in the UnitedHealth case.
We are introducing the Behavioral Health Coverage Transparency Act in the House and Senate to crack down on discriminatory practices that prevent patients from accessing care and contribute to the stigmatization of behavioral health needs.
Our bill would strengthen enforcement of existing mental health parity laws by increasing mandatory federal audits of health plans, requiring insurance companies to disclose how they make decisions on behavioral health care coverage, and establishing a Consumer Parity Portal. The portal would be a one-stop shop where consumers could learn about their rights and submit complaints about their insurers.
The federal government would force insurance companies to actually respond to consumer complaints and also could analyze this data to inform its broader enforcement efforts.
Since we first introduced the Behavioral Health Coverage Transparency Act several years ago, the coalition of mental health and addiction treatment advocates and providers supporting this effort has grown.
We’ve called on the Trump administration to use all of the tools at its disposal to strengthen mental health parity laws, but its efforts are lagging. The mandated health plan audits and the consumer portal in our bill would require this administration to work harder to enforce the parity laws already on the books.
Health care is a basic human right, and discrimination has no place in our society, much less our health care system. It’s long past time to get back to work building an equitable, affordable, and universal health care system that guarantees health care to everyone in Massachusetts and across this country.
US Senator Elizabeth Warren of Massachusetts is a Democratic presidential candidate. Joe Kennedy III is a US representative from Massachusetts.