Everything You Need To Know About the Mental Health Parity and Addiction Equity Act

This is the law in place to protect your access to mental and behavioral healthcare.

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It’s no secret that society often treats mental and behavioral healthcare as less important than physical healthcare. According to the National Alliance on Mental Illness (NAMI), it can take people an average of 11 years to get treatment after experiencing symptoms, and stigma still causes people to hide their mental health condition or substance use disorder. 

“Having accessible mental and behavioral healthcare is extremely important given work and personal life demands, past traumas, and the current political climate in the country,” says Charlie Health Licensed Creative Arts Therapist, Brooke Cortez, MSW, MT-BC, NMT. Because private insurance dominates the United States healthcare system, in-network coverage is essential for making this kind of access a reality — and the lawmakers behind the Mental Health Parity and Addiction Equity Act (MHPAEA) have taken steps to make this possible. 

Read on to learn more about this critical piece of legislation, designed to provide greater access to mental health and substance use disorder treatment. 

What is the Mental Health Parity and Addiction Equity Act?

Simply put, the MHPAEA stops health insurance companies from offering worse benefits for mental health and substance use disorder care than they do for medical and surgical care. It is a federal parity law that necessitates equality for financial requirements, annual and lifetime dollar limits, and treatment limits. 

Here’s a brief overview of how the MHPAEA came into being, including how it has evolved to expand mental health coverage and protect access to vital behavioral health services:

1996: Mental Health Parity Act

The MHPAEA grew out of the 1996 Mental Health Parity Act (MHPA). The MHPA banned large group health plans from limiting annual or lifetime dollar spends on mental health benefits that didn’t exist for medical or surgical benefits. 

2008: Paul Wellstone and Pete Domenici MHPAEA

Then 2008 brought the passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) — named for the MHPA’s co-authors, Senators Paul Wellstone and Pete Domenici. The new iteration added more protections and extended equitable coverage to include substance use disorders. Notably, the law didn’t require insurance companies or group health plans to offer mental health or substance use disorder benefits. 

2010: Affordable Care Act essential health benefits

But, in 2010, the Affordable Care Act brought something called essential health benefits. It required non-grandfathered health insurance coverage to offer benefits in at least ten different categories, such as emergency services, maternity and newborn care, and pediatric care. 

The essential health benefits categories also include mental health and substance use disorder services, including behavioral health treatment. This addition meant that individual and small group plans have to cover services such as: 

• Behavioral health treatment, such as psychotherapy and counseling
• Mental and behavioral health inpatient services
• Substance use disorder treatment

Marketplace plans also must cover pre-existing mental and behavioral health conditions. They can’t deny coverage or increase the price because of these conditions. 

2013: Further expansion of the MHPAEA scope

A 2010 interim final regulation and a 2013 final regulation further detailed the MHPAEA’s scope. For instance, they stated that definitions of medical or surgical and mental health or substance use disorder benefits had to align with current medical guidelines. They also further explain that benefits include not just services but also items. 

2024: Current scope of the MHPAEA

Most recently, the US Departments of Health and Human Services (HHS), Labor, and the Treasury amended and added new regulations to the MHPAEA. These 2024 updates include a requirement that plans and issuers spend time reviewing their data to see if there are differences in benefits between medical or surgical ones and mental health and substance use disorder ones. 

The significance of insurers covering mental health and substance use disorder care 

Mental health conditions and substance use disorders have a history of being ignored. Treatments for these conditions are often inaccessible due to high fees or limited coverage. Yet, many people across the US live with mental health and substance use disorders.

According to the 2024 National Survey on Drug Use and Health, 48.4 million (16.8%) of people aged 12 or older lived with substance use disorder in the last year. It was almost a direct split between people living with alcohol use disorder or drug use disorder. 

The same survey found that 61.5 million (23.4%) adults lived with a mental health condition in the past year. It rose to 33.2% when looking just at adults aged 18 to 25. At the same time, 5.6% of all adults had a serious mental illness. 

Access to care is critical for so many people’s daily functioning and ability to live healthy lives. “Substance use treatment not only addresses and promotes clean and sober living, but also provides support for those individuals who have experienced past trauma or other challenging family experiences that have impacted their sobriety,” says Cortez. 

Cortez notes that mental healthcare access provides people with support, education, coping strategies, and community. She adds that insurers offering coverage “would assist in decreasing the stigma of mental health diagnoses that many Americans face, which further adds to the need for treatment.” 

How Charlie can help

If you or a loved one is struggling with your mental health, Charlie Health can help. Charlie Health is a virtual behavioral health provider delivering high-acuity treatment for kids, teens, and adults facing serious mental health conditions and substance use disorders. Our innovative treatment model combines clinical expertise, group connection, and measurement-based care to support long-term healing. We are proud to partner with most major commercial insurance providers and Medicaid to ensure broad mental health coverage and affordable access to our virtual behavioral health services. With the right support, managing your mental health and relationships is possible. Fill out the form below to start healing today.