H.R.957 - Parity Enforcement Act of 2025 (119th Congress)
Summary
H.R. 957, the Parity Enforcement Act of 2025, aims to strengthen the enforcement of mental health parity requirements by introducing civil monetary penalties for violations. The bill amends Section 502 of the Employee Retirement Income Security Act of 1974 (ERISA) to include plan sponsors, service providers, and plan administrators in the scope of entities that can be penalized for failing to meet parity requirements. These requirements ensure that mental health and substance use disorder benefits are treated no differently than other medical benefits.
The bill specifically targets failures to meet the requirements of Section 712 of ERISA, which deals with parity in mental health and substance use disorder benefits. It also expands the enforcement authority of the Secretary, allowing them to enforce Section 712 directly. The amendments will apply to group health plans for plan years beginning one year after the enactment of the Act.
In short, this bill seeks to hold health plans and administrators accountable for parity violations, ensuring that individuals receive the mental health and substance use disorder benefits to which they are entitled.
Expected Effects
The primary effect of this bill will be increased compliance with mental health parity laws. By introducing monetary penalties, the bill incentivizes group health plans and administrators to adhere to parity requirements.
This should lead to improved access to mental health and substance use disorder treatment for individuals covered by these plans. The expansion of the Secretary's enforcement authority will also allow for more effective oversight and enforcement of parity regulations.
Ultimately, the bill aims to reduce disparities in healthcare coverage and ensure that mental health is treated with the same importance as physical health.
Potential Benefits
- Improved Access to Mental Healthcare: By strengthening enforcement, the bill ensures that individuals have better access to mental health and substance use disorder benefits.
- Greater Accountability: The introduction of civil monetary penalties holds plan sponsors, service providers, and administrators accountable for parity violations.
- Reduced Healthcare Disparities: The bill aims to eliminate disparities between mental health and physical health coverage, promoting equity in healthcare.
- Enhanced Enforcement: Expanding the Secretary's enforcement authority allows for more effective oversight and enforcement of parity regulations.
- Increased Awareness: The bill may raise awareness among employers and health plans about the importance of mental health parity.
Potential Disadvantages
- Increased Administrative Costs: Compliance with the new regulations and the potential for penalties may increase administrative costs for health plans and employers.
- Potential for Litigation: The introduction of civil monetary penalties could lead to increased litigation related to parity violations.
- Complexity of Compliance: Ensuring compliance with parity requirements can be complex, particularly for smaller employers or health plans.
- Unintended Consequences: There is a risk that some employers may reduce benefits or coverage in response to the increased costs and regulatory burden.
- Limited Scope: The bill primarily focuses on enforcement and may not address other barriers to mental healthcare access, such as stigma or workforce shortages.
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution, as it aims to improve access to mental healthcare and reduce healthcare disparities. While the Constitution does not explicitly address healthcare, the promotion of the general welfare is a broad goal that can encompass healthcare policy.
Furthermore, the bill does not appear to infringe upon any specific constitutional rights or liberties. It does not restrict freedom of speech, religion, or assembly, nor does it violate due process or equal protection.
Congress's authority to regulate employee benefits and health insurance stems from the Commerce Clause (Article I, Section 8), which grants Congress the power to regulate interstate commerce. ERISA, which this bill amends, is a well-established exercise of this power.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).