Mary Schmeida

State mental health parity mandates

&NA; Discrimination toward individuals experiencing mental illness, substance abuse, and addiction has led mental health advocates in the United States to challenge inequitable health care insurance coverage for mental health care benefits. The Mental Health Parity Act of 1996 was passed to eliminate mental health insurance discrimination in the private sector. As mandated, mental health care benefits provided by larger commercial employers are to be equitable in terms of treatment limitations and financial requirements with physical health care benefits. On the federal level, mental illness is defined as the severe biologically based mental illnesses, for the 1996 law. Parity legislation for substance abuse and chemical addiction has been introduced in Congress and legislation is being introduced and passed across the states. Although the Democratic Party historically has been the champion of health and welfare programs, there is growing bipartisan support for mental health, substance abuse, and addictions parity legislation. Current reform measures are an incremental step toward better access for the treatment of psychological illnesses for all groups, including women. This research examines the adoption of mental health parity laws across the fifty states. Two hypotheses are tested: 1) States with a higher percentage of Democrats in the legislature will be more likely to pass mental health parity laws, and 2) States with a higher managed care penetration rate will be more likely to pass mental health parity laws. Logistic regression and ordered logistic regression analysis, using 50‐state data, indicate that party control of the state legislature is strongly related to both the passage of mental health parity laws and more comprehensive parity laws. Cluster analysis indicates that states which have passed mental health parity mandates tend to have more Democrats in the state legislatures and, surprisingly, lower percentage of the population enrolled in HMOs.

Children’s Mental-Health Language Access Laws: State Factors Influence Policy Adoption

Despite federal legislation to equalize healthcare for children with limited English language proficiency, some state healthcare agencies and programs fall short in providing children’s linguistic services for mental healthcare. While some states have been aggressive in passing cultural and linguistic laws aimed at providing protection for children, other states have not, limiting children of all ages to potential substandard care. This research uses state-level data and multivariate regression analysis to explore why some states are adopting these laws, whereas others are not. We find two dissimilar forces with unrelated goals must work in tandem to bring about policy change—the desire of civil rights and liberty groups to ensure equality in the delivery of healthcare services, and the desire of state legislature to reduce healthcare costs.