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Publication Date

2010

Abstract

American health care reform has drawn both impassioned critics and vociferous supporters. Although underinsured and uninsured Americans face a dire plight, the mentally ill-even those with private health insurance-confront even greater hurdles. While drawing substantially less outcry, many insurance plans place limits on mental illness coverage that do not apply to physical illnesses. Though Congress recently passed the Mental Health Parity and Addiction Equity Act of 2008 (the MHPAEA), it did not solve the problem. The MHPAEA eliminates some disparity-such as higher deductibles for mental health treatment-but still allows insurers to impose unequal annual coverage limits. Furthermore,the MHPAEA shares the glaring flaw of earlier federal mental health parity legislation: it does not mandate coverage of any mental illnesses. Thus, due to the higher costs associated with treating mental illnesses equally, the MHPAEA gives insurers incentives to cover fewer mental illnesses or to drop mental illness coverage entirely. This Note proposes federal parity legislation that mandates the coverage of certain mental illnesses. Congress should model the legislation on successful state solutions that require equal coverage for a list of serious mental illnesses. Congress would select mental illnesses based on three factors: prevalence, severity, and biological basis. These criteria-particularly the biological underpinnings of the mental illnesses selected-will counter objections to the proposed legislation that are concerned with the subjective nature of mental illnesses. Additionally, this Note will address cost concerns relating to such legislation and ultimately present a feasible solution to the dire need for mental illness insurance parity.

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