Sixteen years after MHPAEA, enforcement and implementation will finally be strengthened.
Washington, DC (September 9, 2024): Some 16 years after its passage into Federal Law, today The Kennedy Forum salutes the Biden-Harris administration’s announcement of new rules governing the enforcement of our co-founder’s signature legislation, The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA).
Stewarded in the House by Co-Founder Patrick J. Kennedy (D-RI) and in the Senate by his father, the late Senator Edward M. Kennedy (D-MA), MHPAEA ensured that mental health and substance use care were treated equitably in coverage with medical/surgical care.
“The Kennedy Forum has relentlessly fought for greater parity in the U.S. with a drumbeat of policy leading to bold moments of change,” noted Co-founder Patrick J. Kennedy. “This is one of them. Parity supports tens of millions of Americans who seek help each year, strengthening our families, communities, workforce, and economy. I’m so grateful to the Biden-Harris Administration for this Parity Rule, so that individuals and families can get better access to mental health and substance use disorder care. I’m proud that The Kennedy Forum was able to launch both ParityTrack.org and Don’tDenyMe.org to help support the creation of this rule.”
The rule implements a straightforward and transparent framework for MHPAEA by focusing in on what really matters most – can people enrolled in health insurance plans equitably access mental health and substance use care?
We know now that the answer is no. The recent report by RTI, Behavioral Health Parity – Pervasive Disparities in Access to In-Network Care Continue, shows that patients went out-of-network 3.5 times more often to see a behavioral health clinician than a medical/surgical clinician, 8.9 times more often to see a psychiatrist, 10.6 times more often to see a psychologist, 6.2 times more often for emergency behavioral inpatient care, and 19.9 times more often for non-emergency behavioral inpatient care. These numbers demonstrate that in-network care is insufficient, and forcing patients out of network is more expensive for them, and shifts the burden for finding quality care and qualified providers to patients and families. This is wrong and adds a further burden to individuals and families who are already challenged by the need for this care.
The new rule will also offer an important mechanism for reining in healthcare costs in the long-term. As a recent study by the Deloitte Health Equity Institute and the School of Global Health at Meharry Medical College showed, the United States will spend an estimated $477.5 billion in avoidable and unnecessary expenses related to mental health inequities in 2024, with that number potentially soaring to a staggering $14 trillion by 2024 unless these inequities are addressed. Coupled with the potential for lost productivity and insufficient workforce, it’s clear that the country needs an aggressive way to stop these losses before they have significant impact on our economy.
“The cost of the status quo is simply too high for the country to continue to pay,” said Rebecca O. Bagley, President & CEO of The Kennedy Forum.” The economic impacts of inequitable mental health and substance use care have national and global economic implications for the United States, and we call on insurers and employers to work with The Kennedy Forum and the Administration to find a way forward to make the parity a reality.”
The United States is in a mental health and addiction crisis, exacerbated by the isolation and upheaval of the COVID-19 pandemic, and coupled with insufficient mental health providers and inadequate financing of care. The World Health Organization estimates that 12 billion working days and $1 trillion in productivity globally are lost to mental health issues per year. As the U.S. faces a rapidly declining workforce pool, increasing demand for care, and fewer providers overall, these losses could prove economically cataclysmic. We must consider the potentially immense long-term economic benefits of a healthier society facilitated by this care.
To ensure investments in this care are meaningful, policymakers, providers and payors must embrace and pursue a more data-driven approach. This is why The Kennedy Forum is calling for a new public health north star to revolutionize the way mental health and substance use are addressed in the U.S.: by 2033 90% of the population are screened for mental health or substance use; that 90% of those needing treatment receive quality, evidence-based care; and that 90% of those receiving treatment are able to manage their symptoms and live in recovery.
The Kennedy Forum will host virtual events for partners and advocates to learn more about the rule and will be leading a team of policy professionals who will contribute to a Gold Standard Toolkit aimed at state regulators.
About The Kennedy Forum
Since 2013, The Kennedy Forum (TKF) has been leading a national effort to transform the way mental health and substance use disorder are treated in our healthcare system. Going into 2024, we have set our strategic focus on shepherding an inclusive movement that will ensure every person in the United States has access to the mental health and substance use treatment services and supports they need. Founded by Former Congressman Patrick J. Kennedy, who led a coalition of diverse stakeholders to pass the bipartisan Mental Health Parity and Addiction Equity Act, TKF has leveraged our unique role to coalesce a growing set of partners to advance the next generation of mental health and substance use disorder policy, including expanding insurance coverage, increasing access to evidence-based treatment, and improving health outcomes.
To demonstrate the breadth and depth of this systems change movement, TKF amplifies organizations’ efforts, inviting organizations to join the Alignment for Progress (A4P) by making a commitment to the movement. Building a strong coalition helps further develop the A4P agenda and guides TKF in planning a series of issue-based convenings to drive the movement forward. TKF’s goal is to bring closer the future where mental illness and substance use disorder are prevented when possible and, when not, treated effectively and equally for all patients. We see mental health as essential health.
To learn more about The Kennedy Forum, please visit www.thekennedyforum.org.
