2/4/2009 1:59:19 AM
HOFSTRA LABOR & EMPLOYMENT LAW JOURNAL
Federal Parity: The Mental Health Parity Act of 1996
The Mental Health Parity Act of 1996 (“MHPA I”)96 amends portions of the Employee Retirement Income Security Act (“ERISA”)97
by requiring specifies that benefits,99 the
if a group health plan chooses to provide mental health plan may only place annual and aggregate lifetime limits
if such limits are applied to substantially all other
benefits.100 There insurer to provide
is no language in the MHPA coverage for mental illnesses
medical and surgical I requiring a group if such coverage is
entirely absent from their benefits package.
The MHPA I therefore lacks the necessary teeth to force insurance providers to cover mental illnesses, and a hypothetical scenario seems to sweep this impotence under the rug. Code of Federal Regulations § 146.136, promulgated under the MHPA I, contains an example of the MHPA I in practice: if prior to the effective date of the MHPA I a group health plan did not have an annual limit on medical/surgical benefits but had a $10,000 limit on mental health benefits, the regulation lists three methods of MHPA I compliance for the plan sponsor.102 They can: (1) remove the limit from mental health benefits; (2) replace the $10,000 limit with a $500,000 limit on all benefits (“including medical/surgical
96. The Mental Health Parity Act of 2007 will be referred to as “MHPA II” in this Note and is discussed in detail infra.
Employee Retirement Income Security Act of 1974 § 2, 29 U.S.C. § 1001 (2000).
45 C.F.R. § 146.136(b) (2007).
29 U.S.C.A. § 1185a(b)(1) (2007) (“Nothing in this section shall be construed as requiring
a group health plan (or health insurance coverage offered in connection with such a plan) to provide any mental health benefits . . .”). This subsection makes the name “Mental Health Parity Act” a misnomer. “Parity” is defined as “the state or condition of being the same in power, value, rank,
WEBSTER’S NEW WORLD COLLEGE DICTIONARY 1047 (4th ed. 2001).
dictionary definition of “parity” is not achieved by the Mental Health Parity Act of 1996, because it leaves the decision regarding mental benefits solely to the discretion of the insurance company/employer. The Mental Health Parity Act would be more accurately titled “The Mental Health Mandated Offering Act of 1996,” as mandatory benefit laws do not always require mental illness coverage.
See Maria A. Morrison, Changing Perceptions of Mental Illness and the Emergence of
Expansive Mental Health Parity Legislation, 45 S.D. L. REV. 8, 17 (2000) (citing 29 U.S.C. § 1185a(b)(1), Oversight of Tax Law Related to Health Insurance: Hearing Before the Subcomm. On Oversight of the H. Comm. on Ways & Means, 105th Cong. 54 (1998) (statement of James A. Klein, President Ass’n of Private Pension & Welfare Plans)); Sara Noel, Comment, Parity in Mental Health Coverage: The Goal of Equal Access to Mental Health Treatment Under the Mental Health Parity Act of 1996 and the Mental Health Equitable Treatment Act of 2001, 26 HAMLINE L. REV. 377, 388 (2003) (citing 42 U.S.C. § 300gg-5(b)(1)(2000)).
102. 45 C.F.R. § 146.136(b)(4)(i) (2007).