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: Sen. Warren, Elizabeth [D-MA]
Target Audience
Population: Individuals with mental health or substance use disorders
Estimated Size: 51500000
- The bill affects individuals who utilize mental health services, as it targets insurance coverage for mental health and substance use disorders.
- People with insurance that may not currently fully cover behavioral health conditions will be impacted by the increased oversight and potential improvements in coverage.
- Since mental health and substance use disorders are prevalent globally, this legislation could indirectly influence policies and insurance practices outside the U.S.
- Mental Health America estimates about 970 million people worldwide live with a mental disorder, which could be an audience for improved global practices inspired by the US legislation.
Reasoning
- Approximately 51.5 million U.S. adults living with mental illness based on estimates will be the main beneficiaries. Given the budget constraints, direct intense intervention can only reach a fraction of that number.
- The policy might primarily lead to increased enforcement of existing parity laws, potentially influencing insurance practices in beneficial ways without directly providing services.
- Individuals are likely to report varying levels of benefit from government intervention based on their current insurance and mental health status.
- The population likely contains a mix of highly affected individuals, moderately affected, and those barely affected based on individual insurance policies and their oversight levels.
- Given the estimated cost, many benefits of the policy might depend on gradual improvements in systems rather than immediate widespread change.
Simulated Interviews
Graphic Designer (San Francisco, CA)
Age: 30 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- My insurance isn't very consistent with covering therapy or meds.
- If they start covering more, I’d feel less financial stress.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Factory Worker (Detroit, MI)
Age: 54 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Insurance has always been sketchy with mental health. It'll be good if they have to improve.
- But I'm not sure how much will actually change or trickle down to me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
College Student (Boston, MA)
Age: 19 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- Dad says our insurer may not be great with mental health.
- Better transparency would definitely help us navigate what's covered.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 8 | 7 |
Full-time Parent (Austin, TX)
Age: 42 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Coverage has been a nightmare; if this forces insurance to pay up, amazing.
- I'm waiting to see if they actually follow through.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Retired (Rural Kentucky)
Age: 63 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- More transparency might help if they send information in ways we can actually access out here.
- It's hard to imagine them listening to small voices like ours.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Software Engineer (Seattle, WA)
Age: 37 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- I’m fortunate, so I'm not too worried personally.
- Policies like this might help those who aren’t as lucky as me.
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 | 9 | 9 |
| Year 20 | 9 | 9 |
Restaurant Manager (Denver, CO)
Age: 28 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- If they’re forced to listen to the rulings about parity, it could seriously help me.
- I just want my insurance to stop squeezing me at every turn.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Self-Employed (Tech Consulting) (New York, NY)
Age: 45 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- This bill could possibly help standardize what's expected from my insurers.
- Better coverage transparency is a win.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Teacher (Chicago, IL)
Age: 60 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- I don't personally feel I need this change, but I know many colleagues struggling because their plans don't match mine.
- Could help teachers dealing with difficult classroom situations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Hospitality (Miami, FL)
Age: 22 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- Finally, someone might make insurance companies pay attention.
- But will they actually fall in line or is this just paper enforcement?
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 7 | 3 |
Cost Estimates
Year 1: $25000000 (Low: $20000000, High: $35000000)
Year 2: $25000000 (Low: $20000000, High: $35000000)
Year 3: $25000000 (Low: $20000000, High: $35000000)
Year 5: $25000000 (Low: $20000000, High: $35000000)
Year 10: $25000000 (Low: $20000000, High: $35000000)
Year 100: $25000000 (Low: $20000000, High: $35000000)
Key Considerations
- Insurance compliance costs could transfer to consumers or change the premiums structure for mental health coverage.
- The long-term impact of equitable mental health coverage could include reduced workplace absenteeism and higher productivity.