White House pushes private insurance companies to cover mental health care

President Joe Biden's administration plans to try to force private insurance companies to offer the same coverage for mental health services as they do for physical health services, improving upon a well-known hole in America's health care system, according to the White House.

The new policy is part of a broader push by Biden to improve mental health care in the United States -- an issue he raised during one of his State of the Union speeches. The proposed rule, which Biden announced on Tuesday afternoon, will attempt to enforce compliance from private insurers with a 2008 law that already requires equality between the way insurance companies cover mental health and physical health -- but is hardly ever adhered to.

"That law was passed to ensure that mental health care was treated by our health care system, like physical care," Biden's domestic policy adviser, Neera Tanden, told reporters during a recent telephone call. "Insurance couldn't make you pay more for a visit to a mental health provider than your physician."

"But in the years since, we've learned that insurers are evading the mandate of law," she added. "Insurers make it difficult to access mental health coverage in-network, and then consumers are often forced to seek care out-of-network at significantly higher cost and pay out of pocket. Or -- and this is this is also a real challenge -- they defer care altogether."

The new rule will attempt to crack down on violations of this law by creating more reporting standards and also try to get more mental health professionals to offer in-network care as well as reduce the "red tape" to qualify for mental health coverage, according to senior White House officials.

After monitoring the way the current system works for the past few years, one official called it "incredibly disappointing" and largely not compliant with the 2008 law. Analyses showed that people can access nutritional counseling if they have diabetes, for example, but not if they have eating disorders.

The proposed policy, an official said, will "put a lot more teeth around how health plans have to actually measure parity."

Exactly when it will be enacted was unclear, though officials said "sometime in the near future." The policy will undergo a 60-day public comment period before implementation. The effectiveness of the rule will be under the watchful eyes of mental health advocates.

On Tuesday afternoon, Biden spoke about the new rule from the White House's East Room and said that his plan would “identify the gaps in the mental health care that [insurers] provide.”

Insurers would need to collect data on what makes it so difficult to get mental health covered under the current system. That includes how many mental health providers are available in-network, whether insurers are paying them enough to incentivize being in-network, how hard it is to join their network and how much they require patients to prove that they need mental health care in order to get it covered.

"I don't know what the difference between breaking your arm and having a mental breakdown is," Biden said. "It's health. There's no distinction. It's health."

And he lamented the fact that "seeing a therapist can cost 200 bucks a visit or more -- that's $800 a month if you have a session every week, which is often what patients need."

“We have a moral obligation, in my view, to be there for each other," Biden said, "to reach out, reach to our neighbors in grief and stress and trauma and despair, reach out to them to offer help or just a listening ear, to have the courage to ask for help when we need it -- and it's hard."

Tuesday’s announcement follows through on a pledge the president made during his State of the Union address in March 2022.

"Let's get all Americans the mental health services they need," Biden said at the time. "More people they can turn to for help, and full parity between physical and mental health care."

Around the same time, the Biden administration began to move nearly $1.7 billion of mental health funding from the Bipartisan Safer Communities Act, which the president signed in June 2022, to schools and communities across the country. That included $240 million for programs increasing awareness of mental health support for school-aged kids, $80 million for grants for children's mental health services and $60 million to train pediatric providers. In addition, that law had $150 million to help implement the 988 suicide and crisis lifeline, a hotline for people to contact when they're in need.

It was all part of a major push by Biden to improve the nation's mental health care, including $300 million in grants focused on mental health services that were part of his fiscal year 2022 budget.

In May, the U.S. surgeon general, Dr. Vivek Murthy, issued an advisory about the impact of social media usage on teenagers' mental health -- an issue Biden also highlighted in his State of the Union speech.