Health Resource Package: Mental Health Parity
Congress Asks . . .
Has Mental Health Parity Legislation Been Effective? How Much Does Improved Mental Health Coverage Cost?
RAND Health Research
Federal and state legislation mandating equal coverage for mental health benefits has had little effect.
- Copayments and deductibles for mental health benefits offered through employer-sponsored plans did not change significantly between 1995 and 2000.
- State parity mandates have not measurably increased access to mental health care or use of mental health care services.
- Compared with the general population, individuals with mental health problems have experienced deterioration in their health insurance status. These people are also more likely to have lost their health insurance.
Implementing parity under managed care has negligible cost effects.
- Under managed care, the cost consequences of improved coverage for mental health care are minor. Estimates based on the actual experience of large employers range from $1 to $7 per year per enrollee. The higher estimate reflects a generous plan with no limit on inpatient or outpatient treatment, no deductible, and minimal copayments.
- On a per-member basis, most of the increased expenditures for mental health care have been for children, rather than for employees or adult dependents.
References
This fact sheet is based on the following publications:"Are People with Mental Illness Getting the Help They Need?" 2000; RAND RB-4533 (HTML or print-friendly version).
"How Does Managed Care Affect the Cost of Mental Health Services?" 1998; RAND RB-4515 (HTML or print-friendly version).
Pacula RL, Sturm R. "Mental Health Parity Legislation: Much Ado About Nothing?" Health Services Research. 2000; 35(1):261-273.
Sturm R. "How Expensive Is Unlimited Mental Health Care Coverage Under Managed Care?" JAMA. 1997;78(18): 1533-1537.
Sturm R, Wells K. "Health Insurance May Be Improving--But Not for Individuals with Mental Illness." Health Services Research. 2000;35(1):251-260.
Sturm R, Pacula RL. "State Mental Health Parity Laws: Cause or Consequence of Differences in Use?" Health Affairs. 1999;18(5):182-192.
Sturm R, Pacula RL. "Mental Health Parity and Employer-Sponsored Health Insurance in 1999/2000: Limits." Psychiatric Services. 2000;51(11).
Sturm R, Pacula RL. "Mental Health Parity and Employer-Sponsored Health Insurance in 1999/2000: Copayments and Coinsurance." Psychiatric Services. 2000;51(12).
For more information, contact Shirley Ruhe at (703) 413-1100, extension 5632, or by email at ruhe@rand.org.
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