President Trump should ambrace stronger, smarter mental health parity

The Hill

7 hours ago

As someone in long-term recovery and an advocate for those battling addiction and mental health conditions, I've seen countless families shattered and lives lost because desperately needed care was out of reach. Often, the barrier isn't a lack of effective treatments, but how insurance coverage for the mind is treated as less important than for the body. This is why the current juncture regarding the Mental Health Parity and Addiction Equity Act is so critical, and why I urge President Trump to not just preserve but to boldly strengthen parity for all Americans.
The Mental Health Parity and Addiction Equity Act, a landmark 2008 bipartisan law, was meant to end this discrimination. It requires health insurance for mental health and substance use disorders be no more restrictive than for medical or surgical care. Yet, for millions, this promise remains elusive. Insurers adeptly use opaque 'non-quantitative treatment limitations' — like restrictive prior authorizations, unequal network adequacy and disparate reimbursement rates — to deny or limit care.
In September 2024, a final rule from the previous administration aimed to close loopholes and enhance enforcement. However, after a January 2025 lawsuit, the Trump administration announced in May a pause on enforcing the 2024 rule. It is now reconsidering, modifying or even rescinding the final rule.
While some see this pause as a setback, I see it as a pivotal moment — an opportunity for President Trump to champion mental health and addiction parity with unprecedented force, truly making America healthy again. This isn't about more burdensome regulation; it's about smarter, fairer rules that save lives and money.
The Trump administration has laid groundwork for this. In his first term, Trump signed Executive Order 13877, 'Improving Price and Quality Transparency in American Healthcare to Put Patients First,' noting 'opaque pricing structures may benefit powerful special interest groups…but they generally leave patients and taxpayers worse off.' This led to the 2020 Transparency in Coverage Final Rule, forcing insurers to disclose actual pricing.
More recently, the president's February 2025 Executive Order 14221, 'Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information,' doubled down, stating, 'For far too long, prices were hidden from patients and employers … [allowing] powerful entities … to operate with insufficient accountability,' This executive order directs agencies to crack down on evasive pricing and reinvigorate Transparency in Coverage Rule enforcement, mandating public disclosure of actual prices and standardized data.
Here lies the powerful convergence: The president's drive for insurer transparency is key to unlocking true mental health parity. Discriminatory practices thrive in darkness. When insurers must bring their mental health provider reimbursement rates, network adequacy standards, and addiction treatment prior authorization approval rates into daylight — alongside medical/surgical data — disparities become undeniable and indefensible.
As The Kennedy Forum recently stated, 'Strong parity implementation will support the Administration's goals to reduce wasteful spending, promote transparency and efficiency, and Make America Healthy Again. The Administration's actions to make health insurance data transparent and actionable can also advance parity, providing insights into provider access, service coverage, and reimbursement issues.' They noted this would 'continue President Trump's legacy from his first term, when he advanced parity implementation and signed into law the bipartisan statute building on parity.'
This is President Trump's chance to go further than any administration. Instead of merely tweaking or reinstating the 2024 rule, he must direct the departments of Health and Human Services, Labor and Treasury to craft even stronger parity regulations. These new rules should explicitly integrate the robust transparency mandates from his executive orders.
Imagine insurers compelled to publicly disclose complete non-quantitative treatment limitations analyses in a standardized format, showing how they apply limitations to mental health benefits compared to physical health benefits. This data must include clear metrics on network adequacy, directly comparing in-network mental health specialists to medical specialists, alongside detailed reimbursement rates.
Furthermore, crucial data on claim denial rates, prior authorization timelines and out-of-network use for mental versus medical services must be readily accessible and regularly updated for public scrutiny.
By leveraging the president's championed transparency, he can create a largely self-enforcing parity framework. Public exposure of discrimination will pressure insurers to comply with the law's spirit and letter, reducing future need for costly government enforcement. It empowers consumers, employers and researchers to hold insurers accountable.
This approach is about fiscal responsibility and public health. Untreated mental illness cost our nation hundreds of billions annually (some estimates approach nearly $477.5 billion in 2024) in lost productivity, increased health care spending and criminal justice involvement. Ensuring access to care is an investment yielding healthier families, productive communities and a stronger nation.
The pause on the 2024 Parity Final Rule, while concerning, can be a strategic reset — an opportunity for decisive leadership, making President Trump's transparency agenda the engine for true mental health parity. While agencies were tasked by EO 14221 to act by late May on transparency enforcement, the president's direct intervention now can ensure transparency and parity move forward together.
President Trump has often spoken of tackling the overdose crisis and national health challenges. True mental health and addiction parity is central to that mission. It means a treatable brain illness faces no greater barriers than a treatable body illness. The president should build on his health care transparency legacy and deliver a transformative victory for millions. Trump must seize this moment to champion a new era of accountability. Ensure 'Make America Healthy Again' unequivocally includes the mind. The lives of countless Americans hang in the balance.
Ryan Hampton is a national addiction recovery advocate and author of two bestselling books on the overdose crisis: 'American Fix' and 'Unsettled.' His latest book is 'Fentanyl Nation.'