Parity Rules Determined: Significant on Many Levels


We are pleased to share a guest blog post from our Manager of Aftercare Planning Katherine Swain McClayton, MPH. Katherine is on the board of the Eating Disorders Coalition and is excited to share, first hand, the recent change in parity rules, decided upon last Friday, November 8th.

Last Thursday I was in Philadelphia for the Eating Disorders Coalition (EDC) annual Board Retreat. We discussed policy goals, upcoming lobby days, special events, fundraising, and other important goals to further develop the EDC’s mission of advancing the recognition of eating disorders as a public health priority through advocacy. There was talk of the guidelines for parity coming out soon, but many felt “we will believe it when we see it.”

The mental health field was surprised and excited to receive the rules on parity that came out the next day, last Friday, November 8th. The rules on parity are a big win for mental health, especially residential treatment for eating disorders and substance abuse. It looks promising for fair, responsible coverage for mental health services.

First, a little history: In 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was passed by Congress. This law requires health insurance to cover both mental and physical health equally. MHPAEA states that you cannot put limits on mental health services that are different from physical health. The 2008 MHPAEA law was an expansion on the original mental health parity law, passed in 1996, to include language for those facing addiction problems. MHAPEA also states there cannot be higher co-pays and deductibles for mental health and substance abuse than for physical health issues.

Specifically to eating disorders, MHPAEA is a historic moment for paving the way for increased comprehensive access to treatment. Regarding residential treatment coverage, it does not state verbatim that residential be covered, but uses the language that a plan covering “post-acute care services” must also cover residential treatment for mental health. For instance, if one’s plan covers residential rehabilitation after an accident for physical injuries, it must also provide comparable residential treatment for eating disorders. The Eating Disorders Coalition has fought for fair coverage within plans between mental and physical health. This regulation explicitly clarifies this, which is incredibly significant.

I believe the rules on parity are an icebreaker in the constant battle that mental health care has to wage for a voice, coverage, and fair treatment not only in making sure individuals can receive care, but in our everyday society. I remind people when I advocate, or just in casual conversations, that the brain is a big and important organ in the human body, yet I feel it can be treated as a second-class citizen. Mental health issues are not a choice, they are not something to be “snapped out of” or “gotten over.” Mental health struggles are to be carefully and skillfully considered, treated, monitored, and understood. I feel very fortunate to use my voice on behalf of Oliver-Pyatt Centers and all the women, families, and people I meet in advocating as a Board Member of the Eating Disorders Coalition.

To become involved and for further reading, please visit the following sites:

APA Help Center: Parity Law

Eating Disorders Coalition

Eating Disorders Coalition blog

Kaiser Health News: Health on the hill, mental health parity regulations