On Friday, January 17, 2025, ERIC announced that it filed a lawsuit in the U.S. District Court for the District of Columbia against the U.S. Departments of Labor, Health and Human Services, and the Treasury (the Tri-Departments) challenging the Biden Administration’s changes to mental health and substance use disorder parity regulations under the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and the Consolidated Appropriations Act of 2021 (CAA). This rule goes far beyond the Tri-Departments’ statutory authority, violates the Due Process Clause of the Fifth Amendment, is arbitrary and capricious, and otherwise violates the Administrative Procedure Act.
For nearly 20 years since President George W. Bush signed MHPAEA into law in 2008, ERIC has sought to advance workable solutions that ensure employees have access to mental health and substance use disorder care. The law improved coverage of mental health and substance use disorder benefits and was a significant step in addressing America’s mental health crisis. Employers who voluntarily offer health coverage worked alongside the Tri-Departments to implement the law as intended to benefit millions of workers and their families.
However, the Tri-Departments’ recent final regulations greatly exceeded the intent of Congress and their regulatory authority. The Tri-Departments manufactured a parity standard that is completely unworkable and could lead to worse, not better, access to mental health and substance use disorder care.
Over the past 15 months, ERIC and other aligned groups urged the Tri-Departments instead to focus on addressing mental health workforce shortages, better connecting patients to available mental health care providers, and improving training for primary care physicians to care for patients with mental and behavioral health conditions.
In October of 2023, during the open regulatory comment period, ERIC formally submitted concerns about the proposed changes, outlining several serious potential implications. If finalized, ERIC warned that the new rule would be overly burdensome to employer-sponsored health benefit plans and impossible to comply with, resulting in millions of employees and their families paying higher costs for critical mental health and substance use disorder services.
ERIC subsequently launched a TV and digital ad campaign publicly opposing the changes. One month later, ERIC sent a letter to the White House detailing its concerns and urged President Biden to consider the potential implications.
Former U.S. Senator Heidi Heitkamp (D-ND) and Constance Garner, former policy director at the Senate HELP Committee under then-Chairman Ted Kennedy (D-MA), who helped draft MHPAEA, also spoke out against the proposed rule, pointing out how the change would lower standards of care and complicate finding eligible providers for patients in need or critical services.
ERIC repeatedly warned the Biden Administration that this was a step in the wrong direction when it comes to addressing the current mental health crisis in the United States. Despite these efforts, the Tri-Departments finalized the rule in September of 2024, leaving ERIC with little recourse.
ERICresponded to the administration’s issuance of its Final Rule with a statement warning that the new regulations created “unintended consequences that will raise costs and jeopardize patients’ access to safe, effective, and medically necessary mental health support.”
A law that expanded access to mental health and substance use disorder services for millions of Americans and their families has taken a wrong turn. The Tri-Departments’ rule ignores standards of quality care and reduces access to critical services with more red tape. A workable solution must be established to salvage the purpose and intent of MHPAEA, and all the years of good faith compliance and implementation employer-sponsored health benefit plans have invested in ensuring workers and their families can access much needed mental health and substance use disorder care.
Follow along for updates on ERIC’s lawsuit on our MHPAEA page or on LinkedIn.