Ten years after the passing of the Mental Health Parity and Addiction Equity Act (MHPA), the AMA is calling for greater enforcement and oversight of this landmark legislation as physicians face challenges related to the opioid epidemic.

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The MHPA was signed into law by President George W. Bush in October 2008, and it requires that annual and lifetime dollar limits on mental health benefits be no lower than any such dollar limits for medical and surgical benefits offered by a group health plan or health insurance issuer.

Prior to its passing, insurers were not required to cover mental health care, which limited access. "The law's much-needed reforms improved opportunities for care and reduced the stigma of having a mental health or substance-use disorder," said AMA President-elect Patrice A. Harris, MD. "Yet, an overwhelming number of people needing treatment for an addiction are not receiving it. Clearly, we have a long way to go."

The 2017 National Survey on Drug Use and Health found that 92 percent, or 19.7 million people, with an SUD receive no treatment, and 57 percent, or 46.6 million people, with a mental illness receive no treatment.

"Insurers need to be held accountable for complying with their legal obligations," Dr. Harris said. "This means that health insurance companies must have addiction medicine and psychiatric physicians not only in the network but accepting new patients."

Physicians and policymakers can learn more about parity, including how to file a complaint, from resources developed by the American Psychiatric Association (APA) and the American Society of Addiction Medicine (ASAM). The APA and ASAM are member organizations of the AMA Opioid Task Force.

The Iowa Medical Society (IMS) hosted AMA President Barbara L. McAneny, MD, in Iowa City, Iowa, where she had the opportunity to interact with health care leaders and professionals from across the state. Dr. McAneny, an alumnus of the University of Iowa (UI) Carver College of Medicine, visited the UI medical campus along with IMS President Michael Romano, MD, and Marygrace Elson, MD, IMS President-elect.

They met with Carver faculty and students as well as hospital administrators and health care providers at the University of Iowa Hospital to discuss a variety of topics, including the state of health care in Iowa and the importance of being involved in organized medicine at the state and national levels.

She also delivered the Grand Rounds at the Holden Comprehensive Cancer Center and visited the impressive Stead Family Children's Hospital, one of just two comprehensive children's hospitals in Iowa.

Dr. McAneny capped off her trip by addressing the IMS Board of Directors meeting where her remarks focused on physician leadership in the future of health care, emphasizing that physicians bring tremendous economic and cultural benefits to communities, but are operating under difficult conditions.

She stressed the need to put patients and physicians first by removing the obstacles and burdens that interfere with patient care, confronting the increasing chronic disease burden, reimagining medical education, training, and lifelong learning, and protecting coverage for all Americans.

"The decisions we make today will have a lasting impact on generations to come, and they're counting on us to get it right," Dr. McAneny said.

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