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H 7946Health Insurance

Insurance - The Protect Mental Health Act

This bill requires health insurers to cover mental health and substance use disorder services equally to medical and surgical services.

In committee
Population
Affected
72
Email Legislator
Introduced Feb 27, 2026Committee House Health & Human Services

Plain-English Summary

The "Protect Mental Health Act" mandates that health insurance companies in Rhode Island provide coverage for mental health and substance use disorders that is comparable to their coverage for medical and surgical conditions. It requires insurers to analyze their data to ensure they are not imposing stricter limitations—such as network availability or administrative hurdles—on mental health care than on physical health care. If disparities are found, insurers must take corrective action. Additionally, the bill requires insurers to cover "core treatments" for mental health in every category where they cover standard medical treatments.

For younger readers

This law is about making sure health insurance is fair. Sometimes, insurance companies make it harder to see a doctor for feelings or thoughts (mental health) than for a broken arm. This bill says that insurance companies have to follow rules to treat both kinds of sickness the same way. They have to show proof that they aren't making it extra hard to get help for mental health. If they are making it too hard, they have to fix it so people can get the care they need.

Who & Where It Applies

Impacted groups
Health InsurersPeople with Mental Health ConditionsPeople with Substance Use DisordersHealthcare ProvidersInsurance Policyholders
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
None
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Significantly expands access to essential mental health and substance use disorder treatment, ensuring that care is available to vulnerable populations who are often marginalized by the current healthcare system.
  • Imposes strict accountability measures on private insurance corporations by requiring them to prove through data that they are not discriminatorily limiting care, thereby checking corporate power.
  • Promotes systemic reform and equity in healthcare by legally mandating that mental health be treated with the same importance and coverage levels as physical health, helping to reduce stigma.
  • Continues to rely on the for-profit private insurance industry to deliver care rather than establishing a universal public healthcare system, leaving coverage tied to employment and ability to pay.
  • The enforcement mechanism depends heavily on the insurance commissioner requesting documentation, which may result in slow or inconsistent oversight depending on the administration's priorities.
  • While it mandates "meaningful benefits," it does not explicitly eliminate all high out-of-pocket costs like deductibles and copays, which can still act as a barrier for low-income individuals.
For Conservatives
  • Could potentially reduce public costs associated with unaddressed mental illness and substance abuse, such as homelessness and interactions with law enforcement, by ensuring private insurance pays for treatment.
  • Ensures that consumers receive the specific insurance coverage they have paid for, upholding the principle of contract integrity between the policyholder and the insurer.
  • Provides support for families dealing with addiction and mental health crises, potentially stabilizing family units and reducing the strain on state-funded social safety nets.
  • Imposes significant new regulatory burdens and reporting requirements on private insurance companies, interfering with the free market and corporate autonomy.
  • Will likely result in increased insurance premiums for all policyholders as insurers pass on the administrative costs of compliance and the expense of expanded coverage mandates.
  • Tethers state law to specific federal regulations (89 Fed. Reg. 77586), ceding state sovereignty to federal bureaucrats and expanding the reach of government into private business operations.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 58 additions

SECTION 1. Title 27 of the General Laws entitled "INSURANCE" is hereby amended by adding thereto the following chapter: 27-38.3-1. Parity compliance and meaningful coverage.

(a) If a health plan provides coverage for mental health and substance use disorder services, any cost-sharing requirements for mental health and substance use disorder services and any treatment limitations, including quantitative treatment limitations and nonquantitative treatment limitations, related to mental health and substance use disorder services shall comply with the requirements in the provisions of Requirements Related to the Mental Health Parity and Addiction Equity Act, 89 Fed. Reg. 77586 (Sept. 23, 2024). (b)(1) Each health insurer shall collect and evaluate relevant data, in connection with its comparative analyses, in a manner reasonably designed to assess, for each nonquantitative treatment limitation and within each classification of benefits, the impact of the nonquantitative treatment limitation on relevant outcomes related to access to mental health benefits and substance use disorder benefits as compared to medical and surgical benefits. With respect to nonquantitative treatment limitations related to network adequacy and composition, the health insurer shall collect and evaluate relevant data in a manner reasonably designed to assess the aggregate impact of all such nonquantitative treatment limitations on access to mental health benefits and substance use disorder benefits as compared to medical and surgical benefits within each classification of benefits.

(2) If the relevant data evaluated under this subsection indicate that a nonquantitative treatment limitation contributes to material differences in access to mental health benefits or substance use disorder benefits as compared to medical and surgical benefits within a classification of benefits, such differences shall be considered a strong indicator of noncompliance with the federal Mental Health Parity and Addiction Equity Act of 2008 and may subject the health insurer to enforcement action pursuant to this title, and the health insurer shall submit to the commissioner documentation of reasonable actions that have been or are being taken to address the material differences and to ensure compliance, in operation, with parity requirements within fifteen (15) working days of a request from the commissioner.

(c) A health insurer shall, as part of the comparative analyses required pursuant to 42 U.S.C. § 300gg-26(8) and this section, demonstrate that none of the information, evidence, sources, or standards on which a factor or evidentiary standard is based are biased or not objective in a manner that discriminates against mental health benefits or substance use disorder benefits as compared to medical and surgical benefits.

(d) An insurer providing coverage pursuant to this section for mental health benefits and substance use disorder benefits in any classification of benefits shall provide meaningful benefits for such mental health benefits and substance use disorder benefits in every classification in which medical and surgical benefits are provided. For purposes of this subsection, whether benefits are meaningful shall be determined in comparison to the medical and surgical benefits provided in the same classification and shall require, at a minimum, coverage of benefits for that mental health benefit or substance use disorder benefit in each classification in which the insurer provides benefits for one or more medical and surgical benefits. An insurer does not provide meaningful benefits under this subsection unless it provides benefits for a core treatment for that mental health benefit or substance use disorder benefit in each classification in which the insurer provides benefits for a core treatment for one or more medical and surgical benefits. If there is no core treatment for a covered mental health benefit or substance use disorder benefit with respect to a classification, the insurer shall not be required to provide benefits for a core treatment in that classification but shall provide benefits for such mental health benefit or substance use disorder benefit in every classification in which medical and surgical benefits are provided. For purposes of this subsection, “core treatment” means a standard treatment or course of treatment, therapy, service, or intervention indicated by generally accepted standards of mental health or substance use disorder care. 27-38.3-2. Relation to other mental health coverage laws. The requirements of this chapter are in addition to, and shall not be construed to limit or reduce, the obligations of health insurers under chapter 38.2 of this title or any other provision of state or federal law governing coverage of mental health or substance use disorder services. 27-38.3-3. Severability. If any provision of this chapter or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect the other provisions or applications of the chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are declared to be severable.

SECTION 2. This act shall take effect upon passage.