In 2008, President Bush signed the Mental Health Parity and Addiction Equity Act (MHPAEA into law. The MHPAEA of 2008 requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care. MHPAEA was expanded to ensure that qualified plans offered on the Health Insurance Marketplace cover many behavioral health treatments and services. The aim of the Parity Act is to eliminate restrictions on mental health and substance use coverage – like annual visit limits, higher copayments, separate deductibles, and rules on how care is managed (such as pre-authorizations, fail first policies, or medical necessity reviews).
A year and a half later, in March 2010, the Affordable Care Act (ACA) became law. In the years since full implementation of the ACA, the availability and scope of coverage for mental and substance use disorder treatments have been further enhanced through regulations. In December 2016, Congress built on this foundation through enactment of the 21st Century Cures Act, which directs more funding to treatment for mental and substance use disorders. To preserve improvements in health insurance coverage, proposals to change the health insurance market should attend to the key elements of reforms established by the MHPAEA, the ACA, and the 21st Century Cures Act.