Mental health parity rules, which require insurance companies to cover mental health care on par with physical health care, are currently at risk of being weakened by the Trump administration’s review and potential suspension of recent federal protections.
This could affect about 25% of Washington state residents who are covered under self-funded employer health plans, including employees of major companies like Amazon and Microsoft.
Mental health parity laws ensure that if a health plan covers unlimited visits for physical conditions such as diabetes or cancer, it must also cover unlimited visits for chronic mental health conditions like schizophrenia.
The original federal Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 but enforcement has been inconsistent, with many insurers failing to comply fully.
For example, patients needing psychological care are over ten times more likely to go out-of-network compared to those needing specialty medical care, indicating limited in-network mental health options.
To strengthen enforcement, Congress passed legislation requiring insurers to report on parity compliance and make corrections if gaps are found. These updated rules took effect recently but are now under review by the Trump administration, which has indicated it may suspend enforcement while reconsidering the rules.
This move follows a lawsuit by large employers who argue that the stricter rules increase costs and limit their ability to offer affordable health benefits.
Washington state has its own strong mental health parity laws, including a new law effective in 2027 that mandates uniform, doctor-approved standards for approving or denying mental health coverage. The Washington Insurance Commissioner has pledged to enforce these state laws regardless of federal changes.
However, these state protections apply only to fully insured plans, not to self-funded employer plans, leaving a significant portion of residents potentially vulnerable if federal rules are weakened.
Mental health advocates warn that weakening parity protections would worsen access to care during a growing mental health crisis. Nearly one in five American adults experience mental health conditions, but only half receive treatment, and many face barriers due to insurance limitations and provider shortages.
Experts emphasize the need for strong parity enforcement, expanded telehealth, and better integration of mental health care into primary care to improve access and outcomes.
In summary, while Washington state maintains robust protections for mental health coverage, the potential rollback of federal parity rules could reduce access for many residents covered by self-funded plans, making it harder for them to get the mental health care they need.
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