The Failed Promise of Mental Health Parity in Virginia: A Missing Key in Mental Healthcare Access

For those who suffer from the most serious mental illnesses, access to mental healthcare is critically important, but often frustrated by a Byzantine insurance system. The goal of this Note is to sift through the various mental health insurance parity laws, both nationally and statewide, and determine where this system breaks down. The Note will argue that lack of enforcement of parity laws plays a critical role in much of the dysfunction in the marketplace. Legislation in Virginia and elsewhere is not always deficient on its face. Instead, laws critically lack regulators willing or able to implement them. This creates insidious problems in the mental healthcare market. The first place to begin enforcement is at the state level, where insurance regulation primarily occurs. The President’s Commission on Combating Drug Addiction and the Opioid Crisis recently recognized the need for greater enforcement of parity laws at the federal level as well. Although this Commission is primarily concerned with substance use disorders, it recognizes the crucial role that the Department of Labor has in enforcing federal parity laws. The DOL currently lacks the tools it needs to enforce these laws. It is encouraging that the Commission’s Final Report recognizes this. Federal recognition of the problem is crucial, and increased enforcement could generate positive results for access to care throughout the country