Parity Implementation Update

GAO report gauges parity law’s impact

Overall results indicate that parity has had a positive effect on employer-provided benefit plans and access and enrollment issues

By Legal and Regulatory Affairs staff

January 12, 2012—The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Parity Act) requires the U.S. Government Accountability Office (GAO) to examine trends in health insurance coverage of mental health and substance use as a means to observe the implementation of parity. In November 2011, the GAO released a report on employer-provided insurance coverage since passage of the federal parity law.

The GAO surveyed a random sample of small, medium, large and very large employers about their most popular health plans for the most recent plan year (2011 or 2010) as well as for 2008 (the year the parity law was enacted). The agency also conducted research into published national employer surveys, conducted interviews and performed literature reviews.

The GAO determined that the mental health/substance use disorder insurance coverage offered by employers has been maintained or enhanced since the Parity Act was passed. Most employers surveyed (96 percent) continued to offer coverage of mental health/substance use disorders.

Additionally, the mental health and substance use diagnoses included in and excluded from employers’ benefit packages remained consistent – with 91 percent of respondents indicating that the same diagnoses were covered in their plans in 2008 and the current year, and 9 percent indicating that they had broadened the diagnoses that were covered.

The GAO also determined that the implementation of parity requirements has led to reduced enrollee out-of-pocket costs.

The report found mixed results on access to mental health/substance use services. Of the 30 studies reviewed by the GAO, some found that access and utilization of services decreased while others found an increase in the number of people initiating mental health treatment. The variation in access and enrollment may be due to the different parity requirements reflected in state parity laws.

Overall, this report provides positive information regarding the impact that parity has had on employer-provided benefit plans and access and enrollment issues. The GAO noted, however, that due to the low response rate, the survey results are not generalizable and future research is needed.

Read the report (PDF, 564KB).

For more information, contact the Legal and Regulatory Affairs department by email or at (202) 336-5889.