Over 15 years after a federal law prohibited health insurance providers from imposing barriers to accessing mental health care, patients still struggle to find adequate services and providers.
The Mental Health Parity and Addiction Equity Act, passed in 2008 as a provision of the Affordable Care Act, was designed to ensure patients have the same access to mental health services as they do for physical health. But, for some people, finding mental health care providers that accept their insurance can be difficult.
UNC junior Kate Doherty said looking for a therapist that takes her insurance, BlueCross and BlueShield of North Carolina, is complicated and time-consuming. She has searched for a therapist online and often has to cross-check with the providers’ websites and make phone calls to verify they will accept her insurance.
Corye Dunn, the director of public policy for Disability Rights North Carolina, said there is a shortage of adequate mental health providers.
To accept insurance, therapists must undergo a lengthy and often intensive application process and wait months for approval, contributing to some of the deficit. And even then, certain insurance companies may not cover all therapy services, meaning therapists must fight for coverage for their clients.
Many therapists are also wary of getting reimbursed when they accept insurance — especially Medicaid — because reimbursement rates are often inconsistent with their own rates.
“And those low reimbursement rates make it really tough for anyone to maintain a practice long-term, especially in rural areas," Dunn said.
Ciara Zachary, an assistant professor of health policy and management at UNC, said even providers that accept a patient's insurance may have long waits for appointments or may not be taking new patients. She said these barriers may motivate patients to look outside their insurance network for providers, which is often more expensive.
Zachary said that when health care providers leave an insurance network, it can be disruptive to patients, as mental health providers often have formed relationships with their patients and understand their personal medical histories.