Trump administration urged to defend mental health parity rules

The American Medical Association (AMA) is calling on the Trump administration to robustly defend the Mental Health Parity and Addiction Equity Act (MHPAEA) amid a lawsuit from the ERISA Industry Committee, which represents large employers. This pivotal law, signed by President Trump in 2020, mandates that health insurers must provide coverage for mental health and substance-use disorders on par with medical and surgical care.

Originally enacted in 2008, the MHPAEA faced significant noncompliance, leading to the establishment of federal regulations aimed at enforcing its provisions. A key regulation implemented in September 2024 aims to clarify these requirements and improve enforcement. However, in January, the ERISA Industry Committee filed a lawsuit to block the implementation of this regulation, prompting the AMA’s urgent request for the administration to act before the May 12 deadline for a response.

The AMA emphasizes that upholding the law aligns with the administration’s commitment to tackling the ongoing opioid crisis, which President Trump declared a national emergency in 2017. The opioid epidemic has severely impacted communities across the nation, affecting individuals regardless of age, socioeconomic status, or geographic location.

In 2018, the administration took further steps by passing the SUPPORT Act, designed to improve access to treatment for substance-use disorders. This legislation specifically reinforced the need for parity in the coverage of mental health services within the Children’s Health Insurance Program. The AMA continues to support legislative efforts to reauthorize the SUPPORT Act as part of a comprehensive strategy to combat substance-use disorders.

The September 2024 rule introduces essential measures to enhance the enforcement of the MHPAEA, ensuring that mental health and substance-use disorder benefits are treated comparably to medical benefits. This includes clarifying restrictions on nonquantitative treatment limitations and mandating data collection to identify and address disparities in treatment coverage.

Past reports indicate that many insurers continue to provide unequal coverage. For instance, a 2022 government study revealed that a health plan offered nutrition counseling for diabetes but denied similar support for conditions like anorexia nervosa, showcasing the disparity in treatment options based solely on diagnosis. The AMA highlighted this ongoing issue in a 2024 issue brief, underscoring the necessity of the new regulations to combat insurers’ noncompliance.

The AMA’s executive vice president, Dr. James L. Madara, strongly criticized the lawsuit, describing it as an attempt to weaken the administration’s commitment to fighting practices that lead to inefficiencies and adverse patient outcomes. He pointed out that the lawsuit threatens to reverse progress made in mental health coverage and treatment access. Dr. Madara emphasized that the September 2024 rule merely clarifies existing legal obligations under the 2008 law, which already requires equitable treatment for mental health services.

Research supports the notion that comprehensive coverage for mental health and substance-use disorders can save lives. As the nation grapples with the implications of the opioid crisis and rising rates of mental health issues, the AMA’s call for the Trump administration to defend the MHPAEA is a critical step toward ensuring continued access to necessary treatment and support for those affected.