Mental health care may be harder to obtain after HHS rule reversal- Trigger warning! This discusses suicide and overdose

[tulipsandroses]

For a recent therapy session, Andria Donaghy’s insurance plan paid her psychiatric nurse practitioner only $11 on a $125 service.

“To even put that on paper is insulting,” she said. “These people give their lives [to help others] and that’s what you pay them?”
Andria Donaghy knows firsthand the value of good mental illness treatment. Her father died of suicide, her cousin’s struggles with bipolar disorder contributed to his drug overdose, and she herself spent decades mired in addiction and depression. A recent complication of her treatment has been her insurance plan’s low coverage rates for mental health services, especially compared to its coverage for medical and surgical services.
When Congress passed the Mental Health Parity and Addiction Equity Act of 2008, the law was supposed to prevent private insurance companies from instituting unequal coverage for mental health and physical health services. It fell short, as multiple federal reports indicated that insurance companies routinely exploited loopholes to avoid paying rates for mental health services that were commensurate with those for other health care. This can lead providers to drop clients and can saddle people with debt. A 2024 survey found that 1 in 4 Americans in frequent mental distress could not see a doctor due to cost.

The Department of Health and Human Services and two other federal agencies attempted to sew up these loopholes in 2024. But it appears that the agencies’ new leadership will walk back these regulatory updates after a lawsuit challenged them. On May 9, three federal agencies, including HHS, notified the judge that they will not force companies to comply with the current regulations, including potentially modifying or rescinding the regulation.
SNIP--- In 2021 and 2022, MHPAEA enforcement removed treatment limitations and expanded access to mental health and substance use disorder benefits for over 4 million participants, beneficiaries, and enrollees across more than 39,000 plans. But these and other hard-fought gains are now threatened by the federal policy reversal.
https://www.statnews.com/2025/05/13/hhs-roll-back-rules-impact-on-mental-health-substance-abuse-care/

[bucolic_frolic]

1. I had to look up psychiatric nurse practitioner.

So there's a hierarchy. Psychiatrist, psychologist, therapist, PNP, as well as a range of specialties. Surprised to see diagnosis as part of PNP duties.

Costs keep pushing duties down the hierarchy.

[tulipsandroses]

3. I'm a psych NP. The role of a psychologist is not the same as the role of a psychiatrist or psychiatric NP

Psychologists do not prescribe medication. Completely different role.

Nurse practitioners have been utilized in healthcare since the 1960's - Due to shortage of MDs.
Many people probably see an NP without realizing they are seeing an NP.
Psychiatric NPs can diagnose, prescribe meds and do therapy - It is part of the training.

[bucolic_frolic]

4. Thanks for the additional background. Google AI was a bit scant on much of that.

I asked "What is a psychiatric nurse practitioner?"

When I stated it is a hierarchy, I was thinking of the pecking order in terms of what stands up in court. Psychiatrists' opinions trump all the rest. (I think, or have read.)

[SheltieLover]

2. They are truly shameless!

[Mike 03]

5. If I'm understanding this correctly:

We are going to make it yet more difficult for Americans to receive mental health care at exactly the same time as we:

Throw a huge number of them into poverty by destroying the social safety net.

Throw 12 million of them off of health care.

Close a bunch of rural hospitals.

Close one quarter of all homes for the elderly and assisted living facilities, and lay people off from the ones that survive.

Remove all the mechanisms the country has to predict, prevent and make people whole again following natural disasters like hurricanes, floods and wildfires.

Make most everything more expensive.

Lay a lot of Federal Workers off, and many other people who work in science and clean energy.

To say nothing of eroding our education system and, more importantly, making it cost prohibitive and riskier to get loans for it.

I'm sure there a hundred things I'm forgetting.

[Silent Type]

6. Unfortunately, the rule wasn't scheduled to start until 1/1/2025. Not sure why it took 16 years after enactment of law

to come out with a clarifying rule, although that’s all too typical of Medicare policy evolution.

And, the real guts of the policy was scheduled to start until 2026– “However, the meaningful benefits standard, the prohibition on discriminatory factors and evidentiary standards, the relevant data evaluation requirements, and the related requirements in the provisions for comparative analyses apply on the first day of the first plan year beginning on or after January 1, 2026.”

Fortunately, there is the 2008 law that is still in place, at least for now.

Prior to 2008, Medicare covered only 50% of most mental health services. Other insurers did the same. That does not appear to be involved in the review of the recent policy.