Congress held hearings on Tuesday and Wednesday on responses to the opioid epidemic and mental health parity. The Senate Health, Education, Labor and Pensions (HELP) Committee unanimously voted to advance the Opioid Crisis Response Act of 2018 while the House Energy and Commerce Committee advanced 57 bills to address the opioid epidemic. NAHU has closely followed this issue as it relates to healthcare externalities, particularly with regard to cost containment, as well as employer issues with mental health parity (MHP) requirements. NAHU was able to successfully prevent an amendment to the Senate legislation that would have enforced onerous penalties for noncompliance with MHP requirements.
The Senate’s bill, S. 2640, is led by HELP Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA), and would expand access to medication-assisted treatment and recovery services. Major provisions of the legislation include reauthorizing federal grants under the 21st Century Cures Act, establishing new funding for comprehensive opioid recovery centers, and increase research on non-opioid pain therapies. Chairman Alexander has indicated he expects the other committees with jurisdiction to take up the package in the coming months for the full Senate to consider the final package sometime this summer.
Ahead of advancing the package through the committee, it passed several amendments related to MHP, including one offered by Senator Bill Cassidy (R-LA). However, the committee rejected a proposed amendment offered by Senator Chris Murphy (D-CT) on a party-line vote that would have increased the Department of Labor’s authority to enforce MHP laws. While the amendment did not pass at this instance, NAHU remains vigilant in ensuring that it is not enacted through the regulatory process or in further legislation that would cause undo harm to employers and employee health benefits.
NAHU and our coalition partners advocated against this amendment on the basis that the penalties could result in a decline of MHP for patients. While MHP is not currently mandated, many employers voluntarily offer high‐quality mental health benefits to employees and their families, to ensure employee health, productivity, and for recruitment and retention. We believe that creating new civil monetary penalties would add undo complexity to understanding and complying with the requirements along with the burden of facing yet another monetary penalty regarding the employer’s offering of insurance to employees. Instead, we advocate that the federal government issue full and clear guidance on complying with requirements prior to implementing enforcement actions without undercutting employer plans’ medical management of benefits.
Finally, in relation to ongoing MHP discussions, NAHU was pleased that the Mental Health Parity and Addiction Equity Act included the self-compliance tool. NAHU specifically requested this in our comment letter on the disclosure form and in a request for information on parity. The inclusion of this compliance resource provides employers and brokers with more clarity on how to remain in compliance with the requirements.