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Fact check: Biden calling ACA 'breakthrough' for mental health parity highlights gaps

Shefali Luthra, Kaiser Health News on

Published in Health & Fitness

In a sit-down interview with CNN, 2020 Democratic presidential primary candidate and former Vice President Joe Biden touted the Obama administration's passage of the Affordable Care Act, asserting that this law evened out the playing field when it came to insurance coverage of mental and physical health.

"We made parity between mental health and physical health," Biden told CNN's Chris Cuomo. "It was a fundamental breakthrough in how we thought about how things should work."

This gets at a health care issue that -- as a federal appeals court weighs Obamacare's constitutionality -- is now particularly relevant. Did the ACA create equal coverage of mental and physical health?

We decided to investigate. We contacted the Biden campaign and never heard back.

But our own reporting shows that while Biden's claim is mostly accurate concerning the health law's provisions, its implementation has yet led to trigger the systemwide changes necessary to achieve the goal of parity.

ONE PROBLEM, TWO LAWS

 

The ACA, which became law in 2010, does include provisions meant to strengthen access to and insurance coverage of mental health care. But it wasn't the first statute to take on this challenge.

Two years earlier, before Barack Obama became president, Congress passed the Mental Health Parity and Addiction Equity Act. It said that if insurance offered by large employers -- an organization employing more than 50 people -- included mental health benefits, it had to structure those benefits, as well as associated copayments or caps on visits, equal to -- "at parity" with -- physical health benefits.

A key thing to note, though, is that this 2008 law did not specifically mandate coverage of mental health services.

Obamacare went further by requiring most plans to cover mental health and substance abuse. And it extended the parity requirement beyond large-employer-sponsored coverage to plans offered by small employers and those bought on the individual market.

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