DOJ halts enforcement of updated Mental Health Parity Act
President Donald Trump’s Department of Justice (DOJ) revealed in a court filing last week that it intends to issue a “non-enforcement policy” for portions of a Biden-era regulation requiring private insurers to provide mental health and substance abuse services in parity with coverage under Medicaid.
The Mental Health Parity and Addiction Equity Act was designed to improve patient access to behavioral healthcare by treating it effectively the same as access to traditional services. Portions of the 2008 law were updated by President Joe Biden's administration and set to go into effect this year—but that may change if the DOJ opts not to enforce it.
The agency said it intends to “reexamine” its position on requiring insurers to comply, at least in part. The rule has faced challenges from medical plan providers who argue it is overly broad. An ongoing court case filed by the ERISA Industry Committee—a lobbying group representing employers—prompted the DOJ’s statement.
ERISA challenged the parity rule, arguing that its compliance requirements are too steep and may have the opposite of their intended effect, causing patients to lose access to their private insurance altogether.
A central issue has been the limited availability of in-network providers for substance abuse treatment and mental health services, forcing many patients to pay out of pocket. The parity rule requires insurers to update their networks and make reasonable efforts to ensure these services are offered at in-network rates and that out-of-network payments don’t exceed what patients pay for physical healthcare.
While ERISA is suing the Department of Health and Human Services (HHS) over the rule’s challenges, the DOJ would ultimately be responsible for enforcement through legal filings, which is why the agency asked a U.S. District Court for the District of Columbia to pause the legal case while it reviews the regulation and its internal plan for forcing compliance.
The DOJ added that it already notified ERISA of its decision to review the guidance, effectively putting the mental health parity rule on hold.
ERISA applauds moratorium on enforcement
In a statement, the employer lobby praised the decision by the Trump administration to stay enforcement.
“Despite extensive efforts to work with the previous administration, the final rule requirements are wholly unworkable, and litigation became the only path to protecting employees and their access to quality, affordable benefits,” President and CEO James Gelfand wrote. “We are pleased that the Trump administration has responded to the lawsuit, will not penalize employers under the rule while the case is pending, and is reconsidering the rule to address the concerns [ERISA] expressed throughout the regulatory process.”
“[The pause by] the Trump administration recognizes the need for greater examination to ensure employers have the clarity and flexibility they need to offer robust behavioral health benefits for a healthy, productive workforce. This critical first step paves the way for the administration to restore a sensible approach to parity rules for mental health and substance use disorder care,” he added.
The ultimate fate of the updated Mental Health Parity and Addiction Equity Act remains uncertain until the DOJ decides on compliance and HHS revises its guidance.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.