Mental Health and Substance Use Disorder Parity Under the ACA

National and state estimates of parity gains through 2017

Caroline Au Yeung, State Health Access Data Assistance Center
Colin Planalp, Research Fellow, State Health Access Data Assistance Center


The federal Affordable Care Act (ACA) expanded access to health insurance coverage for millions of Americans through subsidized individual market coverage and state Medicaid expansions. In addition, the ACA applied mental health and substance use disorder coverage and parity mandates to beneficiaries in the individual and small-group markets and to Medicaid expansion beneficiaries.

This brief, Mental Health and Substance Use Disorder Parity Under the ACA: National and State Estimates of Parity Gains as of 2017, details the mechanisms by which the ACA applied these mandates. It also presents national and state-level estimates of the number of people whose insurance coverage now provides mental health and substance use disorder coverage parity as a result of the ACA. In California, for example, more than eight million people were affected by these new requirements. The report was prepared by the State Health Access Data Assistance Center with support from CHCF.

These estimates provide important context for policymakers and others engaged in the ongoing debate about repealing, modifying, or replacing the ACA.