Biden takes new steps to compel health insurers to cover mental health

Wednesday, July 26, 2023

By Courtney Wise

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Biden Administration announces plan to force insurers to boost mental health coverage

Yesterday, President Joe Biden announced that his administration will push forward with a set of new rules aimed at compelling health insurers to cover the costs of mental health and substance use care as comprehensively as they cover treatment for physical health conditions. Though the Mental Health Parity and Addiction Equity Act, passed by Congress in 2008, ostensibly requires insurers to cover mental health on par with physical health, advocates say insurers continue to operate in ways that restrict insured insured people’s access to mental health treatment.

“I don’t know what the difference between breaking your arm and having a mental breakdown is – it’s health. There is no distinction,” President Biden said in a press conference. “We must fulfill the promise of true mental health parity for all Americans now.” 

MindSite News has reported extensively on the impact of inadequate mental health coverage by health insurers, looking, for example, at the plight of families seeking coverage of autism treatment, and examining previous efforts by the Biden administration to ramp up enforcement of the law.

Yesterday’s announcement received widespread news coverage. STAT News noted that the existing law has not prevented insurers from creating a “whack-a-mole” obstacle course of bureaucracy before having to pay for care out of their own pockets. The Associated Press reported that the proposed new rules “would require insurers to study whether their customers have equal access to medical and mental health benefits and to take remedial action, if necessary.”

The proposed rules, which won’t be finalized until after a public comment period, would also make it harder for insurers to require pre-authorization for mental health treatment, which happens at a higher rate than procedures for physical health care. Further, the new regulations would make it harder for state and local governments to opt out of mental health parity, making healthcare coverage more comprehensive for nearly 90,000 government workers. 

“Today’s actions will help the more than 150 million Americans with private health insurance better access mental health benefits through their own plan,” said White House domestic policy advisor Neera Tanden. “With more stable reimbursement from insurers, we expect much more access to needed care. For the many families out there who are paying out-of-pocket … for the care their loved ones need: Help is on the way.”

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Chicago Mayor Brandon Johnson takes first step to expand mental health access

Chicago’s new Mayor Brandon Johnson campaigned, in part, on a platform to reopen shuttered mental health clinics and increase non-police response to mental health crises. On Monday, his administration took its first step to deliver on the promise when officials and the “Treatment Not Trauma” coalition urged a committee of the City Council to pass a non-binding resolution calling for the reopening of mental health centers and the expansion of mental health staff and of mobile crisis response and prevention teams, according to the Chicago Tribune. 

During his campaign for mayor, Johnson endorsed the goals of Treatment Not Trauma, and he spoke last weekend at a summit organized by the group. “I want people like my brother Leon, who died addicted and unhoused, to have true supportive services that they deserve and need,” he said. “We can’t lose anyone else. We can’t afford it, Chicago.”

Former Mayor Rahm Emanuel, with City Council support, famously closed half of Chicago’s publicly-run mental health clinics in 2011, citing a massive budget deficit. Lori Lightfoot, Chicago’s most recent mayor, said she would reopen the clinics, but her administration ultimately did not do so, in the face of political opposition and data that showed a decline in clinic usage. 

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Looking for love while struggling with your mental health

Dating can be a doozy for anybody, so it makes sense that looking for love while navigating a mental illness can present some serious challenges. Allison Raskin should know. She’s an author who wrote about her experiences with obsessive compulsive disorder in Overthinking About You: Navigating Romantic Relationships When You Have Anxiety, OCD, and/or Depression.

“When I was younger, I was like, ‘You don’t like me or you aren’t ready to commit to me, so I’m going to try and change your mind.’ I would try to wear people down,” Raskin told the Los Angeles Times. “But it was all tied up in these thoughts I was telling myself, that I wasn’t good enough, that I wasn’t lovable.” Everything changed when she learned to be kinder to herself and her brain, she said. 

Kara Lynch, a North Carolina-based blogger and mental health advocate, says learning to live with a mental health condition takes as much work as it does to sustain a healthy relationship. 

Once you’ve accepted yourself though, how do you tell someone you want to date about your illness? Lynch and Raskin both say there’s no perfect time. It’s really up to you and where you see the relationship going. Raskin encourages sharing information a little bit at a time and gauging your potential partner’s response. If they seem dismissive or uninterested, you know to move on. But if they’re curious, ask questions, and actively listen, you’re on the right track. Still, don’t freak out about every reaction. Concern can be a reasonable response. “If you share with someone that you’ve had a suicide attempt, it’s fair for them to have a reaction to that,” Raskin said. “What happens after the initial reaction is what’s really telling.”

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In other news…

What’s it like to live with schizophrenia? In a guest column for the Seattle Times, Joey Wilson wrote about being told by a doctor at age 12 that he would develop early onset schizophrenia by age 18. That’s roughly what happened, and he spiraled until finally receiving effective treatment at age 22. Now 31 years old, Wilson holds an associate degree, is employed, serves as a disability advocate, and hopes to inspire others with schizophrenia to dream big. 

Burnout is driving physicians out of hospitals and away from the field. In a guest column for the Boston Globe, Jesse M. Ehrenfeld, president of the American Medical Association, offers his take on what can make them stay.

Georgia Tech launched a university minor in its School of Psychology called the Science of Mental Health and Well-Being. According to the department’s website, the new area of study aims to “give students practical tools to build mental wellness while exploring the neuroscience behind different aspects of mental health.” 

Roughly one year ago, mental health providers and public health experts in Minnesota began meeting in an effort to reduce mental health hospital stays and increase access to care in the state. After a year of weekly meetings, members say they’ve made some big steps forward. MinnPost reports on the coalition’s progress. 

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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