Congress Ends Discrimination Against Public Employees' Mental Health Coverage

WASHINGTON, Dec. 22, 2022 /PRNewswire/ — Over one million more children and families will now have the mental health coverage they deserve. Today, Congress took a significant step towards realizing the promise of mental health as essential health by passing legislation that will empower over a million more people to access mental health and substance use care by preventing state and local government plans from discriminating against public employees who seek that care. The Senate passed this legislation today and the House of Representatives is expected to pass it tomorrow. The Kennedy Forum championed this important bipartisan action as part of its mission to transform the way mental health and substance use disorders are treated in this country.

Prior to the passage of this provision in the year-end omnibus legislation, estimates suggest over one million public workers and their family members were enrolled in 229 plans nationwide that had chosen to “opt-out” of the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). MHPAEA requires insurers to cover illnesses of the brain, such as depression or addiction, no more restrictively than illnesses of the body, such as diabetes or cancer.

“As a former public servant who benefited from mental health and addiction treatment, I believe no public servant should be subject to discrimination that denies that treatment. Thankfully, we are finally seeing brain health as part of overall health,” said Patrick J. Kennedy, founder of The Kennedy Forum and co-lead author of MHPAEA.

State and local governments that had chosen to strip public workers – many of whom have been on the frontlines throughout the pandemic – of their parity rights include but are not limited to:

Entire states, including Michigan and Utah.
Counties and municipalities, including the City of Chicago.
Public school districts, including the Milwaukee Public Schools.
Public university systems, including the University of Texas and the University of Virginia.
Public hospital systems, including the Uvalde County Hospital Authority (Texas).
Police and fire departments, including in Miami Beach, FL and the State of Washington, respectively.

MHPAEA can be used to challenge wrongful coverage denials of MH/SUD care, but that right was eliminated for the doctors, nurses, teachers, police, firefighters, and other public sector workers covered by plans who had “opted-out.” Further, many of the opted-out plans offer substandard MH/SUD coverage that can endanger the lives of public workers and their loved ones. All this amidst a worsening national mental health and overdose crisis.

“Millions of people and their families will be touched by the mental health provisions in this omnibus package that increase access to care today and build the pipeline of providers for tomorrow,” continued Patrick. “I’m so proud of the work The Kennedy Forum team has done to expand the Federal Parity Act which will guarantee more Americans have access to the lifesaving care they need. Now Congress must act to extend the Federal Parity Act’s protections to all types of health plans nationwide, including Medicare.”

With the passing of this legislation, no new opt outs can be filed by state or local government plans and existing opt outs will phase out, with all plans ultimately being required to comply with MHPAEA.


Since 2013, The Kennedy Forum (TKF) has been leading a national effort to achieve systemic reform in the U.S. health care system by advancing evidence-based practices, policies, and programming for the prevention, treatment, and recovery of brain illnesses – specifically mental health and addiction. Former Congressman Patrick J. Kennedy led a coalition of diverse stakeholders to pass the most transformative legislation in 50 years, the bipartisan Mental Health Parity and Addiction Equity Act. Since leaving congress, he has leveraged that unique role to coalesce a growing set of diverse stakeholders to advance the next generation of mental health and addiction policy through TKF. To learn more about The Kennedy Forum, please visit

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