Discriminatory health insurance practices limit mental and substance abuse healthcare through:

• Lower day and visit limits,
• Higher co-payments and deductibles, and
• Lower annual and lifetime spending caps.

In partnership with state and local MHAs, NMHA advocates for parity for all people with mental health and substance abuse disorders.

NMHA advocates for comprehensive parity legislation over proposals that list out specific diagnoses or serious mental illness (SMI). If used as the criteria in parity legislation, SMI language discriminates against children and adults whose illnesses can also be seriously disabling but do not fit neatly within the SMI diagnoses.

• Advocacy Resource Center
  

• Policy Position Statements Index
  
  Web Resources on Parity
• Mental Health and Substance Abuse Parity Fact Sheet
• What Have States Done to Ensure Health Insurance Parity?
• Why Mental Health Parity Makes Economic Sense
  
  
• Mental Health Policy- Related Links
  
  
• Parity-Related Links

Diagnoses typically excluded in "SMI only" bills include dementia, multiple personality disorders, anorexia nervosa and bulimia, learning disorders associated with brain damage, phobias, post traumatic stress syndrome, substance abuse/addiction, as well as children with serious emotional disorders (SED) - diagnoses that can be just as severe and debilitating as those included in an SMI diagnosis. All categories of the DSM-IV or the ICD should be included in parity legislation.

As of Spring 2001, 32 states have passed some form of parity legislation. NMHA recommends that states use the Vermont, Maryland, or Connecticut laws as a model for their own parity bills. Please contact the Advocacy Resource Center for a copy of these laws.

For NMHA, one of the most crucial issues in passing parity legislation is the inclusion of children and adolescents who need mental health and substance abuse services. The key issue is that most disorders children experience do not fit neatly into common SMI categories. In March 2001, Arkansas passed full parity in its State Children's Health Insurance Program. For more information on children and parity, please contact the Advocacy Resource Center.

Likewise, NMHA believes the time has come to end private health insurance discrimination against individuals with substance abuse problems. For more information on substance abuse, please check out the Substance Abuse section of the NMHA Website, or ask the NMHA Advocacy Resource Center to send you, Substance Abuse Insurance Parity: A Guide for Advocates.

Federal Parity
In 1996, Congress passed the Mental Health Parity Act (P.L. 104-204), which eliminated annual and lifetime dollar limits for mental healthcare for companies with more than 50 employees. This law sunsets in September 2001, and Congress considered legislation in 1999 and 2000 to expand the scope of this law. In March 2001, Senators Domenici and Wellstone introduced the Mental Health Equitable Treatment Act of 2001 (S. 543), which provides full parity for all categories of mental health conditions listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). For additional information on federal parity, please check out the latest legislative alerts in the Federal Affairs section of the website.

Technical Assistance Resources

NMHA has developed a series of resources to help advocates in their parity campaigns. In addition, NMHA will research additional questions on this important topic. The following documents are available through the Advocacy Resource Center:

1. Expanding Mental Health Parity Toolkit. This toolkit provides background information for people who are amending their current parity laws are working to pass parity for the first time. Toolkit contents include: MHA Contact List; Expanding Parity Fact Sheet; Skeleton Media Announcement; State Insurance Parity Laws Charts; Advocacy Check List for 2001; Substance Abuse Insurance Parity: A Guide for Advocates; Media information on the Surgeon General's Report; Why Mental Health Parity makes Economic Sense; State Parity Language for Children; and Parity Case Study: Connecticut.
2. Strategies for Negotiating Comprehensive Parity. Discusses strategies for keeping the parity debate focused on providing protections for all Americans along with specific responses to scenarios that could jeopardize comprehensive or full parity proposals.
3. Substance Abuse Insurance Parity: A Guide for Advocates. Provides background information on the issues surrounding substance abuse parity.
4. Research Studies. NMHA collects research studies on the implementation of parity as well as cost analyses and other research on the topic. Please contact the Advocacy Resource Center if you are interested in some of these more in depth studies.