ArticleJournal of health politics, policy and law2023
Factors Affecting State-Level Enforcement of the Federal Mental Health Parity and Addiction Equity Act: A Cross-Case Analysis of Four States.
Article in Journal of health politics, policy and law, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Mental Health Utilization Gap by Insurance Type Among US Adults With Chronic Pain.JAMA health forum · 2026Article
- Barriers Individuals From Racial-Ethnic Minority Groups Face in Accessing Eating Disorder Treatment and Proposed Solutions.Psychiatric services (Washington, D.C.) · 2026Review
- Long-term services and supports assessments do not adequately address functional limitations associated with serious mental illness.BMC health services research · 2026Article
- Insurance Noncoverage of Interventional Pain Procedures: Paving the Road Toward the Second Prescription Opioid Crisis.Journal of pain research · 2026Article
- Systematic review: the impact of policy levers on mental health service utilization and access for Autistic children.Child and adolescent psychiatry and mental health · 2025Review
- The Public Policy Advocacy Actions Checklist: Success Stories from Three States.Behavior analysis in practice · 2025Article
- Medical Debt and Forgone Mental Health Care Due to Cost Among Adults.JAMA health forum · 2025Article
- Evidence for Public Policies to Prevent Suicide Death in the United States.Annual review of public health · 2025Review
- Mental Health Treatment Access: Experience, Hypotheticals, and Public Opinion.The Milbank quarterly · 2025Article
- Comprehensiveness of State Insurance Laws and Perceived Access to Pediatric Mental Health Care.JAMA network open · 2024Article
- Implementation of state health insurance benefit mandates for cancer-related fertility preservation: following policy through a complex system.Implementation science : IS · 2024Article
- How policymakers innovate around behavioral health: adoption of the New Mexico "No Behavioral Health Cost-Sharing" law.Health affairs scholar · 2024Article
- Revisiting the policy ecology framework for implementation of evidence-based practices in mental health settings.Implementation science : IS · 2023Review
- Implementation of state health insurance benefit mandates for cancer-related fertility preservation: Following policy through a complex system.Research square · 2023Article
- Enforcement of the Mental Health Parity and Addiction Equity Act: State Insurance Commissioners' Statutory Capacity.Psychiatric services (Washington, D.C.) · 2023Article
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Authors and funding
6 authors.
Funding
Abstract
contextThe Mental Health Parity and Addiction Equity Act (MHPAEA) requires coverage for mental health and substance use disorder (MH/SUD) benefits to be no more restrictive than for medical/surgical benefits in commercial health plans. State insurance departments oversee enforcement for certain plans. Insufficient enforcement is one potential source of continued MH/SUD treatment gaps among commercial insurance enrollees. This study explored state-level factors that may drive enforcement variation.
methodsThe authors conducted a four-state multiple-case study to explore factors influencing state insurance offices' enforcement of MHPAEA. They interviewed 21 individuals who represented state government offices, advocacy organizations, professional organizations, and a national insurer. Their analysis included a within-case content analysis and a cross-case framework analysis.
findingsCommon themes included insurance office relationships with other stakeholders, policy complexity, and political priority. Relationships between insurance offices and other stakeholders varied between states. MHPAEA complexity posed challenges for interpretation and application. Policy champions influenced enforcement via priorities of insurance commissioners, governors, and legislatures. Where enforcement of MHPAEA was not prioritized by any actors, there was minimal state enforcement.
conclusionsWithin a state, enforcement of MHPAEA is influenced by insurance office relationships, legal interpretation, and political priorities. These unique state factors present significant challenges to uniform enforcement.
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