National Estimates of Mental Health Insurance Benefits
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Myles Maxfield
Lori Achman
Anna Cook
U.S. Department of Health and Human
Services
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services
Acknowledgments
The authors of this report are Myles Maxfield,
Lori Achman, and Anna Cook, of Mathematica Policy Research, Inc. Other contributors
to the report included Margo Rosenbach, Ama Takyi, Mark Brinkley, Melanie Lynch,
Sharon Clark, and Daryl Hall of Mathematica, and Robert Cohen of Bob Cohen Enterprises.
Judith Teich, of the Center for Mental Health Services (CMHS), Substance Abuse
and Mental Health Services Administration (SAMHSA), U.S. Department of Health
and Human Services (DHHS) was the Government Project Officer, and Jeffrey A.
Buck, Associate Director for Organization and Financing, CMHS, served as advisor.
Disclaimer
Material for this report was prepared by Mathematica Policy Research, Inc. for
SAMHSA, DHHS, under Contract Number 282-98-021, Task Order No. 21. The content
of this publication does not necessarily reflect the views, opinions, or policies
of CMHS, SAMHSA, or DHHS.
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced
or copied without permission from SAMHSA or CMHS. Citation of the source is
appreciated. However, this publication may not be reproduced or distributed
for a fee without the specific, written authorization of the Office of Communications,
SAMHSA, DHHS.
Electronic Access and Copies of Publication
This publication can be accessed electronically through the following Internet
World Wide Web connection: www.samhsa.gov/. For additional free copies of this
document, please call SAMHSA’s National Mental Health Information Center
at 1-800-789-2647 or 1-800-228-0427 (TTD).
Recommended Citation
Maxfield M, Achman L, Cook A. National Estimates of Mental Health Insurance
Benefits. DHHS Pub. No. (SMA) 04-3872. Rockville, MD: Center for Mental Health
Services, Substance Abuse and Mental Health Services Administration, 2004.
Originating Office
Office of the Associate Director for Organization and Financing, Center for
Mental Health Services, Substance Abuse and Mental Health Services Administration,
5600 Fishers Lane, 15-87, Rockville, MD 20857.
DHHS Publication No. (SMA) 04-3872
Printed 2004
Table of Contents
Executive Summary
Mental Health Insurance Coverage
Generosity of Coverage
of Mental Health Benefits
Parity in Mental Health Benefits
I. Introduction
A. Data and Methods
II. Mental
Health Insurance Coverage
A. Sources of Health and
Mental Health Insurance
B. Covered Lives With Health Insurance
C. Mental Health
Insurance Among Those With Health Insurance
D. Total Population With
Mental Health Insurance
E. Summary
III. Generosity
of Mental Health Benefits
A. Generosity
of Mental Health Benefits, by Source of Coverage
B. Summary
IV. Parity in
Mental Health Benefits
A. Individuals
With Parity in Mental Health Benefits in 1999
B. State Mental Health Parity Laws
C. Mental Health Parity Act of 1996
(MHPA)
D. Summary
V. Summary of Findings
VI. References
VII.
Appendix A: Sources of Health and Mental Health Insurance
A. Employer-Sponsored Plans
B. Medicare
C. Medicaid
D. State Children's Health
Insurance Program (SCHIP)
E. Federal Employees
Health Benefits Program (FEHBP)
F. TRICARE
G. Veterans Affairs
H.
Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
I. Indian Health Service (IHS)
J. Individually Purchased Insurance
VIII. Appendix B: Methods
A. Data Sources
B. Methods
IX. Appendix
C: Expert Advisory Panel
X. Appendix D: Mental Health Benefits in Non-Medicaid
S-SCHIP Plans, 2000
Figures
Figure II.1 Primary Source of Health
Insurance Coverage in U.S., by Age, 1999
Figure III.1 Generosity of Mental
Health Benefits in Total U.S. Population, 1999
Figure IV.1. Individuals in U.S.
Population With Parity in Mental Health Benefits, 1999
Figure IV.2. U.S. Population With
Private, Employer-Sponsored Health Insurance Covered by State Mental Health
Parity Laws, 1999
Figure IV.3. Individuals With Private,
Employer-Sponsored Insurance Who Would Have Been Subject to Full Financial Mental
Health Parity Laws in 1999 if All States Had a Parity Law With a Small-Business
Exclusion for Firms With 50 or Fewer Employees
Figure IV.4. Percentage of U.S.
Population Covered by State Full Financial Mental Health Parity Laws in 1999
if Each State Had a Parity Law With No Small Employer Exemption
Figure IV.5. Private, Employer-Sponsored
Health Insurance Market Subject to Mental Health Parity Act of 1996, in 1999
Figure IV.6. U.S. Population Subject
to the Mental Health Parity Act of 1996, 1999
Figure B.1. Maximum Number of Outpatient
Visits Per Year for Firms With Limits on Mental Health Coverage
Figure B.2. Maximum Number of Inpatient Days Per Year
for Firms With Limits on Mental Health Coverage
Tables
Table II.1. U.S. Population by Primary
Source of Health Insurance, 1999
Table II.2. Percentage of Health
Insurance Covered Lives With Inpatient and Outpatient Mental Health Benefits,
by Source, 1999
Table II.3. U.S. Population With
Mental Health Insurance, 1999
Table II.4. Proportion of Population
With Mental Health Insurance, by State, 1999 (Percentages)
Table III.1. Public Sources of Mental
Health Insurance in 1999
Table III.2. Generosity of Mental
Health Benefits Among Individuals With Private, Employer-Sponsored Insurance
Provided by Firms With 10 or More Employees, 1999
Table III.3. Generosity of Mental
Health Benefits Among Those With Health Insurance, 1999
Table IV.1. Full, Financial Parity
in Mental Health Benefits Among Individuals With Private, Employer-Sponsored
Insurance Provided By Firms With 10 or More Employees, 1999
Table IV.2. Parity of Mental Health
Coverage in Public Sources of Mental Health Insurance, 1999
Table IV.3. Financial Parity in
Mental Health Benefits Among Those With Health Insurance, 1999
Table IV.4. States With Full Mental
Health Parity Laws for the Private Group Health Insurance Market, 1999
Table IV.5. U.S. Population With
Employer-Sponsored Health Insurance Covered by State Mental Health Parity Laws,
1999
Table IV.6. State Parity Laws in
the Individually Insured Market in 1999
Table D.1. Mental Health Benefits in Non-Medicaid S-SCHIP
Plans, 2000
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