1. A Political History of Federal Mental Health and Addiction Insurance Parity
- Author
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Barry, Colleen L., Huskamp, Haiden A., and Goldman, Howard H.
- Subjects
Health insurance industry -- Political aspects ,Health insurance industry -- Political activity ,Insurance -- Political aspects ,Mental health -- Political aspects ,Employers -- Political aspects ,Employers -- Political activity ,Behavioral health care -- Political aspects ,Substance abuse -- Care and treatment ,Substance abuse -- Political aspects ,Insurance industry ,Government ,Health ,Health care industry ,Social sciences - Abstract
To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1468-0009.2010.00605.x Byline: COLLEEN L. BARRY (1), HAIDEN A. HUSKAMP (1), HOWARD H. GOLDMAN (1) Keywords: Parity; insurance; mental health; addiction Abstract: Context: This article chronicles the political history of efforts by the U.S. Congress to enact a law requiring 'parity' for mental health and addiction benefits and medical/surgical benefits in private health insurance. The goal of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act of 2008 is to eliminate differences in insurance coverage for behavioral health. Mental health and addiction treatment advocates have long viewed parity as a means of increasing fairness in the insurance market, whereas employers and insurers have opposed it because of concerns about its cost. The passage of this law is viewed as a legislative success by both consumer and provider advocates and the employer and insurance groups that fought against it for decades. Methods: Twenty-nine structured interviews were conducted with key informants in the federal parity debate, including members of Congress and their staff; lobbyists for consumer, provider, employer, and insurance groups; and other key contacts. Historical documentation, academic research on the effects of parity regulations, and public comment letters submitted to the U.S. Departments of Labor, Health and Human Services, and Treasury before the release of federal guidance also were examined. Findings: Three factors were instrumental to the passage of this law: the emergence of new evidence regarding the costs of parity, personal experience with mental illness and addiction, and the political strategies adopted by congressional champions in the Senate and House of Representatives. Conclusions: Challenges to implementing the federal parity policy warrant further consideration. This law raises new questions about the future direction of federal policymaking on behavioral health. Author Affiliation: (1)Johns Hopkins University; Harvard University; University of Maryland Article note: Address correspondence to: Colleen L. Barry, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 403, Baltimore, MD 21205 (email: cbarry@jhsph.edu).
- Published
- 2010