Health and Human Services Secretary Kathleen Sebelius said Friday that a delayed final rule on equal insurance coverage for mental health services will be issued this year, and she stressed that officials are working to ensure that the regulation is integrated with the health care law.
Sebelius also told members of the U.S. Conference of Mayors that 65 million adults will have mental health coverage once the overhaul law (PL 111-148, PL 111-152) goes fully into effect in 2014. A package of essential health benefits is mandated for all individual and small-group plans sold inside or outside the exchanges, as well as Medicaid policies. Mental health and substance abuse coverage is required in those benefits, though how they are configured will vary from state to state. A final rule on essential health benefits is expected in February.
About 60 percent of U.S. adults who need mental health treatment and 85 percent of those who need substance abuse treatment are going without, Sebelius said. “We know that’s even more true of children,” she said.
More than anything, mental illness services must be brought out of the shadows, she said. “Too many people are afraid to seek treatment. Too many parents are afraid to talk about problems their children are having because they’re afraid it will further put their kids in a difficult situation,” she said.
Sebelius’ remarks to a panel of mayors discussing health and education issues at their annual meeting reflected a new emphasis on mental health that’s emerged following the December mass shooting of children at Sandy Hook Elementary School in Newtown, Conn. House Democrats have called on the Obama administration to issue the mental health rule based on a 2008 law (PL 110-343) that requires insurers to offer mental health coverage that’s comparable to medical and surgical benefits (See related story CQ News, Jan. 3, 2013).
Asked by a reporter why it’s taken so long to finalize the rules, Sebelius said HHS wanted to wait and make sure that as the health care law is developed, there is a “synergy” between the two measures and that they are aligned.
“I think the timing is actually going to be very helpful,” she said, adding that interim final rules have been out since February 2010 and have offered some general guidance. More specifics are on the way in the final regulation, she said.
“Definitely this year. We are in the process of finalizing them now,” she said. “It will be done.”
President Barack Obama recognizes that issues of gun use and violence can’t be separated from mental health concerns, Sebelius told the panel. “We know that those with mental health needs are more likely to be victims than perpetrators,” she said, “but that there are definitely situations where violence and mental health issues come together.”
She listed proposals for additional funding that the president laid out earlier this week. They include the training of 5,000 more counselors and other mental health professionals (See related story CQ News, Jan. 16, 2013).
Much of the emphasis will be on young people ages 16 to 25, when mental health problems tend to develop, she said. A yearlong dialogue on mental health is being launched to help people start to talk about stress, depression, substance abuse and more as part of the president’s package of proposals.