Despite Maryland’s relatively low uninsured rate of 6%, a recent report sheds light on a concerning issue: the struggle for insured individuals to access behavioral health services. The report, conducted by the nonprofit research institute RTI International, underscores disparities in coverage for mental health and substance use care compared to traditional medical services.
According to the findings, Marylanders seeking behavioral health professionals like psychiatrists and psychologists are more likely to encounter out-of-network providers, imposing significant financial burdens. This discrepancy in access contradicts the federal mandate outlined in the Mental Health Parity and Addictions Equity Act (MHPAEA) of 2008, which requires equal access to mental health services.
While MHPAEA initially targeted group health plans, subsequent amendments under the Affordable Care Act extended its provisions to individual health plans. However, the report reveals persistent challenges nationwide and in Maryland, where patients face obstacles accessing in-network behavioral health care compared to other medical services.
Key findings indicate that patients are significantly more likely to seek out-of-network behavioral health services, particularly for psychiatrist and psychologist visits, exacerbating the shortage of in-network providers. The disparity extends to telehealth services, reflecting a systemic issue in network availability.
The report attributes this trend to lower reimbursement rates for behavioral health specialists within insurance networks, leading to disincentives for their participation. To address these disparities, the report recommends expanding behavioral health networks and increasing reimbursement rates to incentivize provider participation.
Echoing the report’s concerns, the Mental Health Association of Maryland highlights the state’s lagging performance in access to mental health and substance use care. Marylanders exhibit disproportionately high rates of seeking out-of-network behavioral health services compared to other states, indicating a pressing need for reform.
Efforts to improve parity in behavioral health coverage have gained traction in the Maryland General Assembly. Senate Bill 684, championed by Sen. Malcolm Augustine, seeks to enhance reporting requirements for insurance carriers and bolster enforcement of federal parity laws. Similarly, House Bill 1074, led by Del. Heather Bagnall, aims to strengthen regulatory oversight and accountability in insurance coverage for behavioral health services.
With unanimous approval from both chambers, these legislative measures signal a bipartisan commitment to addressing disparities in behavioral health coverage. As Maryland awaits Governor Wes Moore’s decision on these bills, stakeholders remain hopeful that legislative action will pave the way for improved access to essential behavioral health services across the state.
