Economic Grand Rounds: Parity From the Consumer Perspective: Implications for Federal Implementation From New York's Parity Evaluation

Abstract

This column reports results from a qualitative study of employees' knowledge of and access to mental health benefits after implementation of New York State's parity law in 2007. Fifty-four employed individuals with insurance coverage were interviewed by telephone (32 adults with mental illness and 22 parents of children with mental illness). Contrary to findings of previous studies, most had been informed of their coverage limits before the parity law but were unaware of their extended parity benefits. They cited their lack of knowledge and inadequate communication from their health plan as barriers to accessing benefits. They also reported barriers to accessing high-quality services. The findings indicate an urgent need for benefits education and monitoring of health plan communications on a federal level.

Coverage mandates and market dynamics: employer, insurer and patient responses to parity laws

“…irrespective of firm size). Firms with more than 50 employees were further required to have equal coverage generosity and cost-sharing elements for mental health care relative to medical and surgical care, which applied to a fairly large set of biologically based mental illnesses and children’s emotional disorders (Oziransky et al ., 2011). Oziransky et al .…”

“…Oziransky et al . (2011) provide the lone NY parity study that I am aware of. Using a small-scale qualitative research design, the authors uncover some consumer informational gaps regarding coverage changes post-parity and recommend stronger educational efforts.…”

“…Yet, other studies fail to detect clear benefits from these regulations (Pacula and Sturm, 2000; Bao and Sturm, 2004; Busch et al ., 2014) or find opposing effects for different subpopulations (Andersen, 2015). The inconsistencies in the policy estimates – as well as modest to small effect sizes more generally – are often attributed to insufficient consumer awareness (Mickus et al ., 2000; Oziransky et al ., 2011; Reisinger Walker et al ., 2015) and/or regulation avoidance by employers. The latter is legally accomplished via the Employee Retirement Income Security Act (ERISA), which grants employers with self-insured plans immunity from state-based laws (Buchmueller et al ., 2007).…”