This Article Extract Reprint (PDF) Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content PubMed PubMed Citation

Mental Health

The Sunset Of Federal Mental Health Parity

"The federal MHPA appears to have provided some necessary momentum to the passage of state parity laws," Kevin Hennessy and Howard Goldman conclude, and a substantial number of states that have acted in tandem—the example of Kansas is detailed by state senator Sandy Praeger—have pursued stronger measures.

Daniel Gitterman and colleagues trace a more complex and far-reaching cascade of effects precipitated under the rubric of parity, including state legislation, the Clinton administration’s implementation of a robust "full parity" rule for federal employees, and a "self-reinforcing sequence" of public-private interactions that ensued. "Employers, plans, and insurers reacted to each step, often with a shift to managed care," they explain, as a multiprong drive for expanded mental health coverage raised payers’ concern about costs.

Thanks to analysis by the U.S. General Accounting Office (GAO) and data from the federal employees’ program, projecting the cost of expanded benefits now involves much less guesswork than it did in 1996. The surgeon general’s 1999 report on mental health documented authoritatively the burden of mental illness, the effectiveness of available therapies, and the pervasiveness of undertreatment.

So while some questions facing Congress over the renewal of parity legislation appear to be modest and routine, policymakers are likely to find a bundle of large and difficult issues waiting in the wings.

                      What's this?