Expanding mental health parity

Humboldt County Department of Health and Human Services 24-hour mental health crisis services on August 21, 2019. Photo by Anne Wernikoff for CalMatters

By Jocelyn Wiener


SB 855 would significantly expand the list of mental health conditions considered medically necessary under California’s state parity law. Currently, that law — which seeks to ensure equal levels of care for physical and mental health — covers only nine mental health conditions and does not include substance use disorder. The bill, by Democratic state Sen. Scott Wiener of San Francisco, would require health plans to make decisions about what gets covered based on criteria developed by nonprofit clinical specialty associations, rather than permitting them to make those determinations themselves.


A large coalition of mental health advocacy groups, groups that advocate for low-income and disabled Californians, and associations of mental health professionals. They say commercial health insurers have often failed to provide coverage for mental health care equivalent to care provided for physical health — a situation leading some patients to drop private insurance to qualify for the taxpayer-funded public Medi-Cal system.


The health insurance industry opposes the bill. Representatives say plans are already complying with state and federal parity laws, and that the bill would drive up health care costs.


Mental health care is a growing concern for Californians — and the need for it has been heightened by the pandemic. A recent report from the CDC shows that, since the pandemic began, almost 63 percent of 18- to 24-year-olds nationally reported having symptoms of anxiety or depression in the past month, and more than a quarter said they had seriously considered suicide. Attempts to change the state’s 20-year-old parity law have failed on multiple occasions. If the governor signs this bill, supporters say it would make California the nation’s leader on mental health and addiction coverage.


The governor became emotional while signing a package of mental health-related bills. Referring to opposition to the parity bill, he said:
“This is a big deal to move in this direction. Not everyone is happy with us, guys. Let’s be honest about that. I’ve got a lot of folks that wanted to pull the plug on this Zoom call today. But we’re doing it, because we’re zooming into the future on parity. This is long overdue.”