The paradox of parity: limitations in the breakthrough law for mental health equality.

The intent of parity laws is to improve equity in private insurance coverage for mental health care. The groundbreaking legislation of the 1996 Mental Health Parity Act (MHPA) was initially hailed as a major achievement in improving mental health coverage. However, research suggests that because of political compromises and employer exemptions, the potential impact of the MHPA was weakened. This paper summarizes the extent and scope of the MHPA and the 2008 Mental Health Parity and Addiction Equity Act, highlighting the goals and accomplishments of each; examines limitations of the legislation, explicitly accounting for exemptions, uninsured Americans, and access to care; and provides recommendations for further improvement and implementation of mental health coverage.