This is the second in a series on ERISA at 50.
This year marks the 50th anniversary of the Employee Retirement Income Security Act (ERISA), which has helped ensure that millions of Americans, and their families, receive high-quality health and retirement benefits through their employers.
The 1974 enactment of ERISA was a significant moment in expanding access to healthcare for Americans, which, at the time, focused primarily on medical and surgical care, apart from mental health treatment. Unfortunately, mental health remained a gray area in insurance coverage until 1996 when the Mental Health Parity Act (MHPA) became law.
It was then expanded by the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The goal was to prevent group health plans and health insurance issuers that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on mental health care in comparison to their offered medical or surgical packages. The change did not require ERISA self-insured health plans to provide mental health and substance use disorder coverage to their beneficiaries. However, if they do, they must comply with MHPAEA, one of a handful of federal laws impacting ERISA plans since its inception half a century ago.
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That is why ensuring that MHPAEA and its regulatory standards are workable is critical for maintaining mental health and substance use disorder coverage for Americans who receive it through ERISA health plans.
Now, amid this mental health crisis, a policy proposal threatens to destabilize the infrastructure for mental health and substance use disorder care for millions. The proposed changes to MHPAEA regulatory standards could lower the quality and safety bar for providers to join insurance networks. It could also mean less patient-focused treatment plans tailored to the needs of the individual seeking care — leading to the over- or under-use of appropriate treatment options, including in-patient care.
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With Americans struggling, many agree that we need to increase the number of qualified mental health professionals in hospitals and clinics. Instead of new and costly rules, our efforts should be focused on preventing crises and treating mental health sooner. This is done by providing training for primary care physicians to better identify and treat mental health conditions. It includes allowing qualified, credentialed mental health providers to practice across state lines so patients receive treatment quickly. Rather than erecting obstacles to access to care through telehealth, we should be paring the regulatory morass to drive appropriate use of this medium of care.
Lastly, resources should be directed toward incentives and funding for long-term programs to encourage students and young physicians to join the mental health workforce. And policy ought to provide pathways to retain the talented professionals who are already dedicating their time to this issue.
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ERIC (The ERISA Industry Committee) is committed to working with regulators and all stakeholders to help identify workable policy solutions to ensure better patient access to mental health and substance use disorder treatment. Employers have responded and are committed to finding solutions.
It is crucial that policymakers see the proposed MHPAEA rule change for what it is: A short-sighted attempt to fix a long-term problem. The best way to address America's mental health crisis is to invest in our health care professionals and give them the tools to continue their good work for American patients.
