Bill Overview
Title: Behavioral Health Coverage Transparency Act of 2022
Description: This bill increases oversight of the insurance coverage parity requirements for mental health and substance use disorder, including providing a process for auditing insurance providers and filing formal complaints for violations of the requirements.
Sponsors: Rep. Porter, Katie [D-CA-45]
Target Audience
Population: people requiring mental health and substance use disorder services
Estimated Size: 51500000
- The bill affects individuals who require mental health and substance use disorder services, as it ensures that their insurance coverage is on par with physical health services.
- Globally, mental health conditions and substance use disorders are prevalent and affect a substantial portion of the population.
- According to the World Health Organization, around 970 million people worldwide live with a mental disorder as of recent estimates.
- There is a broad population affected by insurance coverage for mental health worldwide, especially in countries with developed insurance sectors.
- Not all individuals with a mental health condition have or rely on insurance, but those that do are directly impacted by the transparency and parity in coverage.
Reasoning
- The policy targets individuals who either currently face issues with insurance coverage for mental health or substance use services or who may face such issues in the future.
- Given that approximately 51.5 million adults in the U.S. live with a mental illness, focusing on the subset who interact with healthcare systems through insurance is critical.
- By improving transparency and parity, the policy should result in better access and outcomes for those who depend on insurance to access behavioral health services.
- However, not everyone with mental health issues relies on insurance, hence the policy doesn't impact everyone universally, leading to a range of impacts from none to high depending on the individual circumstances.
- Considering the budget constraints, estimating the scale of impact is crucial in determining how broadly the policy can be implemented and enforced.
Simulated Interviews
Human Resources Specialist (New York, NY)
Age: 34 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- I often worry about whether my insurance will cover my therapy sessions comprehensively.
- This law gives me peace of mind knowing there'll be better oversight.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Software Engineer (Austin, TX)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- The Act is necessary to ensure my insurance continues to cover my counseling services.
- I'm relieved that there could be audits as I've faced coverage issues before.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 5 | 2 |
Graphic Designer (San Francisco, CA)
Age: 29 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- Having lost my job, I'm worried more about mental health coverage gaps.
- The Act might help ensure my coverage stays intact during times of transition.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 2 |
| Year 5 | 5 | 2 |
| Year 10 | 4 | 2 |
| Year 20 | 3 | 1 |
Teacher (Miami, FL)
Age: 52 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 18/20
Statement of Opinion:
- Transparent oversight is crucial. I've seen what happens when coverage is denied.
- This Act gives hope to many facing similar battles with insurance companies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Retired (Chicago, IL)
Age: 62 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- Now that I'm retired, my insurance options are confusing.
- I hope this policy will clarify and protect my existing coverage.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 3 |
Freelancer (Seattle, WA)
Age: 26 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- The transparency this law offers is reassuring.
- It could prevent denied claims I've faced in the past.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 3 |
Corporate Executive (Boston, MA)
Age: 40 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- This law seems to provide reassurance for those who use these services, though it's not directly affecting me.
- It seems necessary for those facing insurance battles.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Artist (Denver, CO)
Age: 37 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 14/20
Statement of Opinion:
- I focus more on holistic health, so this policy isn't much relevant to me.
- But I do see its importance for those using mental health services via insurance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
College Student (Raleigh, NC)
Age: 23 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 17/20
Statement of Opinion:
- As a student, my mental health services are limited but crucial.
- This act seems like it could help those like me by ensuring fair coverage.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Construction Worker (Phoenix, AZ)
Age: 55 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- This policy could make it easier to get the coverage I need without constant fights.
- I've had too many issues with claims being denied or limited.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 4 | 1 |
Cost Estimates
Year 1: $50000000 (Low: $40000000, High: $60000000)
Year 2: $25000000 (Low: $20000000, High: $30000000)
Year 3: $25000000 (Low: $20000000, High: $30000000)
Year 5: $25000000 (Low: $20000000, High: $30000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- Initial upfront costs should be offset by potential long-term savings in healthcare expenses.
- The implementation and enforcement of these transparency measures might vary significantly by state, which could affect overall costs.