–Joint Statement by the Medicare Rights Center, Legal Action Center, and Center for Medicare Advocacy–

Across the aisle, and in both the executive and legislative branches, top policy-makers have identified the need for parity in Medicare amidst dual public health crises of overdose and suicide.

Washington, DC – A staggering 93% of Medicare beneficiaries, 65 years and older, with substance use disorder (SUD) do not receive treatment, nor do an estimated 1 in 3 with mental health needs. Further, 38% of those with SUD cite cost as the main barrier to obtaining care, and 26% of those with mental health needs reported the same.

Amidst escalating rates of overdose and mental health disorders, the need to improve access to care is clear. The members of the Medicare Addiction Parity Project (MAPP), are encouraged to see growing recognition of this critical issue at the top levels of government:

• The President’s recently released FY2023 Budget “requires parity in coverage between mental health and substance use disorder – or behavioral health – and other medical benefits, and expands the types of providers covered under Medicare to treat these conditions.” The Budget also calls for the application of the Parity Act, which bars discrimination in insurance coverage of mental health and substance use disorder benefits, to Medicare.

• The Senate Finance Committee’s report “Mental Health Care in the United States: The Case for Federal Action” highlights the lack of parity in Medicare, stating, “insurance companies must be held accountable for putting mental health care on par with physical care. Medicare, Medicaid, and CHIP must also deliver on the promise of parity. There can be no cutting corners in mental health and SUD (substance use disorder) coverage.” Likewise, in a hearing held by the Committee on March 30th, both Senators (including Chair Wyden) and witnesses testified to the same need.

• In a report released by the Government Accountability Office, many of the concerns and recommendations outlined by the Administration and members of Congress, as well as MAPP, regarding limited access to mental health providers and restrictive benefit coverage, were also highlighted.

Ellen Weber, Sr. Vice President for Health Initiatives at the Legal Action Center states, “At a time when fatal overdose is sky-rocketing and rates of substance use disorder continue to increase among Medicare-eligible Americans, it is encouraging to see bipartisan support for addressing the current gaps that exist in Medicare coverage of addiction care. We know that in order to remedy this crisis, parity protections must be applied and the full continuum of care, consistent with the American Society of Addiction Medicine criteria, must be covered and reimbursed. This alone will ensure that the millions of individuals with substance use disorder who are enrolled in Medicare, or soon will be, can access and afford the full range of evidence-based treatment services and supports they need to get and stay well. We look forward to working collaboratively with the Administration, Congress, and CMS to strengthen Medicare and improve health care access and outcomes for countless individuals nationwide.”

Judy Stein, Executive Director of the Center for Medicare Advocacy, says, “Expanding Medicare to include comprehensive coverage for care and treatment of substance use disorders is essential to achieving our goal of health equity and access to quality, comprehensive health care for all Medicare beneficiaries, including the millions of beneficiaries with substance use disorders.”

Fred Riccardi, President of the Medicare Rights Center, says, “We are excited to see both the Biden-Harris Administration and Congress identify concrete and important steps to close gaps and increase equity in substance use disorder and mental health coverage in Medicare. We all see the problem. Now it is time to act by embedding parity into Medicare and covering the full scope of treatment that people need.”

To help boost MAPP’s advocacy efforts, the collaborative is collecting stories from Medicare beneficiaries who have been unable to get the drug or alcohol addiction treatment they need. Stories on behalf of such individuals from friends, family members, and providers are also being accepted. No name or other identifying information is required. To share your story or learn more, visit https://www.lac.org/news/share-your-story-help-us-improve-medicare-coverage-of-substance-use-disorder-treatment.

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About the Legal Action Center: The Legal Action Center (LAC) uses legal and policy strategies to fight discrimination, build health equity, and restore opportunity for people with arrest and conviction records, substance use disorders, and HIV or AIDS. LAC seeks to end punitive responses to health conditions like addiction, mental illness, and HIV or AIDS, and to create equitable access to affordable, quality treatment. Learn more about the Medicare Addiction Parity Project (MAPP) that LAC convenes and which works specifically to improve and expand access to substance use disorder treatment in Medicare by visiting www.lac.org/major-project/mapp.

About the Center for Medicare Advocacy: The Center for Medicare Advocacy is a national, nonprofit, non-partisan law organization that works to advance access to comprehensive Medicare coverage, health equity, and quality health care for older people and people with disabilities through legal analysis, education, and advocacy.

About the Medicare Rights Center: The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives. Since 1989, we’ve been helping people with Medicare understand their rights and benefits, navigate the Medicare system, and secure the quality health care they deserve. We’re the largest and most reliable independent source of Medicare information and assistance in the United States.

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Media Contacts:
Arianne Keegan, Director of Communications
Legal Action Center
communications@lac.org
(212) 243-1313

Matt Shepard
Center for Medicare Advocacy
MShepard@MedicareAdvocacy.org
(202) 293-5760

Deane Beebe, Vice President, Communications & Outreach
Medicare Rights Center
dbeebe@medicarerights.org
(212) 204-6248

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