Connecticut Takes Steps To Strengthen Enforcement Of Mental Health Parity Laws

*

*

*

State officials and advocates gathered Monday to rally behind House Bill 6145, legislation aimed at bolstering enforcement of Connecticut's mental health parity laws that ensure insurance companies provide coverage for mental health and substance use treatment on an equal basis with physical health conditions.

A total of 63 legislators have signed on to introduce the measure, which would require health insurers to submit an annual certification confirming compliance with state and federal parity laws. It also repeals confidentiality provisions that previously shielded insurers' identities in "non-quantitative treatment limitation filings," according to the bill.

Additionally, the bill proposes the creation of a parity advancement account within the General Fund to support enforcement and consumer education initiatives. If enacted, the Insurance Commissioner would be authorized to impose civil penalties on companies that fail to comply.

Attorney General William Tong, Comptroller Sean Scanlon, and other legislative leaders and advocates emphasized that while parity laws exist, compliance remains a persistent issue.

"Mental health parity is the law of the state of Connecticut and of the United States of America. Period. It's not optional. It's not nice to have. It's the law, and you have to follow it," Tong said. "It's our understanding after a few years now of getting information from insurance companies who are reporting anonymously, that the industry and pockets of the industry are not compliant with the law."

Tong highlighted Connecticut's involvement in the ongoing landmark Wit v. United Behavioral Health case before the Ninth Circuit Court, which found that United Behavioral Health wrongly denied mental health and substance use treatment claims using overly strict guidelines that did not align with standard care practices.

He also emphasized the state's ongoing lawsuit against Meta, Facebook, and Instagram over their impact on youth mental health as further evidence of the urgent need for enforcement.

"This is something we're confronting every single day, alongside what is currently the worst public health crisis in America – the opioid and addiction crisis," Tong said. "When people struggle with addiction, they struggle for the rest of their lives. And this is a walk that we will walk with them. That's why coverage, coverage that they're entitled to, is so important."

Rep. Cristin McCarthy Vahey, D-Fairfield, noted the broad impact of mental health and substance use disorders.

"The truth is that everyone is connected with someone who struggles with mental health or substance use disorders," she said. "We're here for the postpartum mom struggling with depression alone at home with an infant. We're here for aging parents dealing with anxiety and depression. We're here for teenagers struggling with their identity. Mental health care is health care."

Scanlon, a key advocate for mental health parity legislation, noted the need for continued legislative action to close loopholes exploited by insurers.

In 2019, as a state representative, he helped pass Connecticut's first mental health parity law, Public Act No. 19-159, requiring insurance providers to submit annual reports detailing their mental health and substance abuse coverage. While the law was a significant step, it did not include penalties for noncompliance.

"In 2019, the legislature unanimously passed meaningful parity reform, but it didn't have the teeth that it needed to realize its full promise," Scanlon said. "The consequences have been severe – longer wait times, financial hardship for families, overburdened emergency rooms, and a shrinking mental health workforce."

Scanlon acknowledged his initial optimism as a freshman legislator but emphasized that insurers have since found ways to circumvent the law.

"You passed the law. So isn't it over? I know that's what I felt when I was a freshman legislator," he said. "I felt so good about myself when I passed my first bill and thought we had fixed all the problems. That's not the way it works. In the six years since, those who profit from the insurance industry have figured out ways around it. We want to work with them to fix this, but in the absence of their action, we have a duty to act. That is what this bill is about."

Dr. Katherine "Kiki" Kennedy, a Yale clinical professor of psychiatry and legislative chair for the Connecticut Psychiatric Society, emphasized that failures in mental health parity affect both patients and providers.

"We are united in this fight because we see firsthand how parity failures harm our patients," Kennedy said. "Mental health clinicians are exhausted. We spend valuable time on the phone explaining to bureaucrats with no clinical experience why our services are medically necessary. When we are burdened with excessive administrative tasks – frequent and arduous prior authorization demands, ill-informed interference in medical decision-making, and improper claim denials – we see fewer patients because there simply isn't enough time."

In 2024, a similar measure, Senate Bill 402, An Act Concerning Mental Health Parity Insurance and Real Estate, was introduced but failed to advance out of committee.

Despite this setback, advocates remain optimistic about the prospects of HB 6145, though they acknowledge that discussions with legislators and the insurance industry will be ongoing.

Asked why neither of the Insurance Committee chairs had signed on as supporters of the bill and whether that raised concerns about its success, Vahey emphasized the ongoing nature of the discussion.

"I think this is going to be an ongoing conversation," Vahey said. "The language of the bill is going to be included in Senate Bill 10. Senator Looney is a supporter who signed on, so the hope is that, through the public hearing process, we will be able to have a conversation with our fellow legislators and talk about why this is important as we move forward together."