In 2008, President George W. Bush signed into law the Mental Health Parity and Addiction Equity Act, requiring insurers to cover mental health as they would any other condition.

    A decade later, states are still catching up, and most—including Idaho—are failing, according to a report released on the law’s 10th anniversary by the Kennedy-Satcher Center for Mental Health Equity, an advocacy group.

    Idaho was one of 34 states to receive a failing grade for its compliance with and implementation of the law, and it’s one of the lowest F’s reported. The state’s score of 36 out of 100 in the study’s metrics ranks ahead of Arizona (26 out of 100) and Wyoming (10).

    The federal law requires insurers to cover illnesses of the brain, such as addiction or depression, no more restrictively than they’d cover illnesses elsewhere in the body, such as cancer or a cardiac issue. Idaho has one law on the books referencing mental-health parity, according to the study. It’s limited to state government employees and their families, and it only ensures “equitable and commensurate” coverage for seven behavioral-health disorders. It does not cover treatment for addiction.

    Without a law in place, private insurers in Idaho reimbursed at a rate 44.6 percent lower for behavioral-health issues than for primary care in 2015, according to a study published last year by the research firm Milliman.

    Lower rates mean fewer providers accepting insurance for mental-health conditions, and, NAMI says, more patients forgoing treatment or going out of network for help.

    Milliman’s data seem to back that up: In 2013, 2014 and 2015, patients were between 10 and 15 times more likely to use an out-of-network provider for outpatient behavioral issues than they were for primary care. That disparity rates among the highest in the nation.

    “This new report highlights what we’ve been saying all along, that people are still being denied mental-health care when they need it the most,” said Christina Cernansky, executive director of NAMI-Wood River Valley. “We hope this will be a wake-up call to the leadership of our state, and we look forward to working with them to ensure greater enforcement of the federal parity law.”

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