APA Services pushed for new rule strengthening mental health care access

The Biden administration finalized a new rule on September 9 designed to ensure that Americans with private health insurance can more easily access mental health services. This will help to rectify a stark disparity highlighted in a 2024 study showing that patients were 10.6 times more likely to go out of networkopens in new window for psychological care than for specialty medical care.

The new rule aims to hold insurance companies accountable for practices preventing patients from accessing mental health care as easily as medical care. It mandates that insurance companies assess whether networks include enough mental health providers to meet patient needs, and how that compares to network access for medical patients. This is crucial, as inadequate networks have left many mental health patients feeling like they are navigating “ghost” networks, where finding an in-network provider is nearly impossible. Most of the new requirements will roll out in 2026.

APA Services, the companion advocacy organization to APA, was a major proponent of this new rule and waged a campaign to encourage members to submit comments to the U.S. Department of Labor in support of the rule. In fact, more than 15% of the total number of all federal comments submitted were from psychologists. In addition, 28 of APA’s state, provincial, and territorial psychological associations submitted comments as well.

Katherine B. McGuire, MSc, APA Services chief advocacy officer, noted that the rule’s publication is the fruit of long years of advocacy led by APA Services staff in close coordination with other national behavioral health consumer and provider organizations. “We would simply not be where we are today without the years of diligent work that we and the mental health community devoted to sounding the alarm that stronger enforcement was needed.”

• Psychologists’ advocacy: APA Services has long advocated for action to address the suffering caused by inadequate mental health care access. The new rule is seen as a major step toward resolving the mental health crisis.
• Regulatory tools: New tools for regulators include requiring insurers to gather and assess data on whether mental health patients have less access to care compared to medical patients. Insurers must take corrective steps to address significant disparities.
• Network adequacy: Agencies supporting parity have recognized that low pay for mental health providers is one major cause of inadequate insurance networks. The rule ensures that insurance networks take reasonable corrective actions if outcomes data shows that mental health patients have less access to care than medical patients.

The 2008 Mental Health Parity and Addiction Equity Act was a significant step towards ensuring that insurance providers offer equal coverage for mental and medical health services. However, as many providers know, the law’s promise has often fallen short, particularly in areas like insurance network adequacy. Patients frequently struggle to find mental health providers who accept their insurance, while providers struggle with administrative demands seemingly unrelated to clinical care and low reimbursements that have not kept pace with inflation or the rising costs of doing business.

Jared Skillings, PhD, ABPP, APA’s chief of professional practice, highlighted the ongoing challenges. “The American Psychological Association knows that many Americans have faced unnecessary suffering because they have been unable to get timely or adequate mental health care through their insurance. We have been hearing for years about the challenges that psychologists face, including bureaucratic hurdles and low reimbursement.” Skillings emphasized the urgency of addressing these issues. “Ignoring mental health costs lives. That’s why we have fought for this action and change. We are optimistic that the new Parity Rule will be a major step toward addressing the nation’s mental health crisis.”

Skillings pointed out that some insurance companies attribute the main cause of network inadequacy to a workforce shortage. However, APA and recent studies disagree, identifying low reimbursement rates as a significant factor. “There is a large pool of psychologists ready to work with insurance companies if treated fairly,” said Skillings.