Mental Health Parity and Addiction Equity Act (MHPAEA, 2008)

1) Link to the Text of the Act
Read the statute (29 U.S.C. § 1185a; 42 U.S.C. § 300gg-26)

2) Why It Was Done
The MHPAEA was enacted to require health insurance plans that offer mental health or substance use disorder benefits to provide them at parity with medical and surgical benefits—meaning no stricter limits or higher costs.

3) Pre-existing Law or Constitutional Rights
The Mental Health Parity Act of 1996 prohibited annual and lifetime dollar limits on mental health benefits but had major loopholes. MHPAEA strengthened and expanded these protections, especially for addiction services.

4) Overreach or Proper Role?
Supporters argue it ended discriminatory insurance practices against mental health treatment. Critics contend it increased healthcare costs and left compliance gaps due to weak enforcement.

5) Who or What It Controls

• Group health plans and insurers (must treat mental health/addiction coverage the same as medical care)
• Employers offering insurance benefits
• Patients (gain expanded access to behavioral health services)

6) Key Sections / Citations

• 29 U.S.C. § 1185a: Employee Retirement Income Security Act (ERISA) parity provisions
• 42 U.S.C. § 300gg-26: Public Health Service Act parity provisions
• 45 C.F.R. § 146.136: Implementing regulations

7) Recent Changes or Live Controversies

• Affordable Care Act (2010): Extended parity requirements to individual and small group plans
• Enforcement remains inconsistent—federal and state regulators continue to issue guidance
• Ongoing debates about whether parity has truly been achieved in practice

8) Official Sources

• U.S. Code – 29 U.S.C. § 1185a
• CMS – Mental Health Parity
• Department of Labor – MHPAEA Overview

• Mental Health
• Addiction
• Healthcare
• Insurance
• Parity