Parity Means Better Coverage for Mental Health and Substance Use Disorder

Close-up of a man consulting with a medical professional, who holds a clipboard.

When the Mental Health Parity and Addiction Equity Act was enacted, the law was considered a landmark achievement by lawmakers and advocates who had been fighting for decades for clearer pathways to mental health and substance use disorder care. Yet, 15 years since its passage, there is still plenty of work to be done to make their vision a reality.

The law doesn’t require job-based health plans to offer any specific mental health benefits. It simply requires that they not make it more difficult for someone to use their plan to access care for a mental health condition or substance use disorder than to access medical or surgical care. The law is grounded in a simple principle – it should be just as easy for someone to get treated for a substance use disorder, anxiety, depression, PTSD or any other behavioral condition as it is for them to get treated for a broken wrist, diabetes, asthma or any other common ailment.

Despite the law’s clear promise of parity between mental health and medical or surgical benefits, that promise has not been kept. People living with treatable mental health conditions commonly face red tape when seeking care, such as unexpected charges, strict preauthorization requirements and provider networks with far too few options available. This is wrong, it’s illegal and it must stop.

If you or your loved ones have ever lived with a mental health condition or wrestled with a substance use disorder, you know how hard it can be to get through the day sometimes, even without added obstacles to needed treatment. I’ve been there myself, and I’ve seen firsthand how difficult it can be for a person in this situation, as well as for their families and friends. I’ve experienced the pain of losing friends and family members to suicide and overdose. And I know that people with mental health conditions and substance use disorders can manage their conditions and lead meaningful, fulfilling lives if they can access the care they need.

That’s why this year the Employee Benefits Security Administration is committed to doing its part to make this system function properly. We're proposing new regulations, committing unprecedented resources to bringing plans into compliance with the law, and reaching out to communities across the United States to ensure that more of America’s workers and families understand their rights and are better able to exercise them, including by contacting us for help when they need it.

We are determined to make sure these workers and beneficiaries get their due. For example, our enforcement program has required plans to address discriminatory practices by:

  • eliminating blanket pre-authorization requirements for mental health benefits;
  • ensuring comparable coverage of nutrition counseling for people with eating disorders, applied behavioral analysis therapy to treat autism, and medication-assisted treatment for opioid use disorders; and
  • eliminating special gatekeepers for mental health and substance use disorder treatment.

If you think you or your loved ones are facing especially high hurdles just to get needed mental health or substance use disorder benefits, call an EBSA benefits advisor for free at 866-444-3272 or ask for help online at We know that too many people in the U.S. deal with these issues every day and may not know where to turn for help. As we continue to work on the larger problems within this system, we are here to help you now. Together, we can move toward a healthier future for all Americans.

Lisa M. Gomez is the assistant secretary for employee benefits security at the U.S. Department of Labor.