The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) sought to improve access to mental health and substance use services. The Health Care Cost Institute, Inc. (HCCI) analyzed mental health, substance use, and medical/surgical inpatient per capita spending, utilization, prices, and out-of-pocket payments for individuals younger than age 65 and covered by employer-sponsored health insurance (ESI) for 2007 through 2011. During the study period, ESI per capita spending nearly doubled for behavioral health admissions and grew to 3.2 percent of inpatient spending. In 2011, mental health admissions grew by 5.9 percent, and substance use admissions grew by 19.5 percent. After 2009, out-of-pocket payments per admission were nearly equivalent for mental health and medical/surgical stays. In all years, out-of-pocket payments per substance use stay remained greater than out-of-pocket payments per mental health or medical/surgical admission. In this initial examination, the role MHPAEA played in the changes observed in 2011 remains unclear.
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