Recently there have been important changes in the legislation surrounding mental health benefits. With the signing of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act in October of 2008 (P.L. 110–343), and more recently the Patient Protection and Affordable Care Act, employer-sponsored health plans are now required to cover mental health/substance abuse services at the same level as medical/surgical benefits. These policy changes may help to reduce the discrepancies between the mental health and non-mental health cost sharing burden as described above. However, insurers are able to opt-out of offering mental health/substance abuse services, or they may elect to cover only specific disorders.(36) Given the high proportion of spending on mental health services among privately insured children with bipolar disorders, it will be important to monitor health plan coverage for bipolar disorder and the impact of benefit changes on children’s health services utilization.
