HR 7780: The Mental Health Matters Act Explained

The Mental Health Matters Act, or H.R. 7780, was a bill introduced during the 117th Congress. While it passed the House of Representatives in 2022, the bill did not become law. The legislation sought to amend the Employee Retirement Income Security Act of 1974 (ERISA) and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Its goal was to address disparities in how health plans cover mental health services compared to medical services by strengthening compliance and enforcement.

Department of Labor Enforcement Authority

The Mental Health Matters Act proposed a significant expansion of the Department of Labor’s (DOL) power to enforce mental health parity. A provision would have granted the DOL the authority to assess civil monetary penalties directly against plan sponsors for violations of the MHPAEA. This represented a change from the DOL’s historical reliance on litigation or voluntary compliance, which can be a lengthy process.

Under the bill, the DOL would have been empowered to levy fines for non-compliance, particularly when a plan failed to provide a sufficient comparative analysis for its non-quantitative treatment limitations (NQTLs). While the bill did not specify the exact penalty amounts, it provided the legal framework for the DOL to establish and impose them, serving as a stronger deterrent.

To support this role, the legislation would have allocated an additional $275 million over ten years to the DOL for MHPAEA enforcement. This funding was designated to enable the department to conduct more investigations and audits of group health plans. The goal was to allow for more proactive identification and penalization of plans that failed to meet parity requirements.

This change addressed findings from government reports that have cited widespread non-compliance with MHPAEA among group health plans. If the DOL found a plan to be non-compliant, and the plan failed to take corrective action, it could have faced financial penalties. The plan would also be required to notify all plan participants of the violation.

Changes to Dispute Resolution and Claims

The legislation included a provision that would have altered how benefit disputes are handled under ERISA. Title VII of the Mental Health Matters Act would have prohibited group health plans from requiring participants to resolve benefit claims through mandatory pre-dispute arbitration. These clauses often force individuals to settle disputes through a private, binding process outside of the court system.

This change would have rendered such clauses, along with class action waivers, unenforceable for claims related to ERISA benefits. As a result, employees and their beneficiaries would have retained the right to file a lawsuit in federal court if they believed their claim for benefits was improperly denied. This would have ensured plan participants had access to the judicial system.

The bill did not seek to eliminate arbitration entirely but to shift the power dynamic. A plan participant and the plan could still have mutually agreed to arbitrate a dispute after it had already arisen. However, this agreement would have to be voluntary, with the plan required to inform the participant in writing of their right to refuse arbitration without retaliation. The participant would also have had a 45-day window to consider whether to agree.

This provision aimed to level the playing field between individuals and large health plans. Proponents argued that mandatory arbitration often favors the plan administrator and can prevent systemic issues from being addressed, as proceedings are private and do not set legal precedent. By preserving the right to go to court, the bill sought to ensure that claim denials could be reviewed by a judge, creating a public record.

Provisions Affecting Educational Settings

The Mental Health Matters Act contained sections aimed at improving mental health support within educational environments. One provision would have clarified that student health insurance plans offered by institutions of higher education are subject to the full scope of federal mental health parity laws. This would have ensured that college students covered by these plans receive the same protections under MHPAEA as individuals in employer-sponsored group health plans.

The bill also would have authorized new grant programs to increase the number of mental health professionals in elementary and secondary schools. It would have provided funding to help high-need local educational agencies recruit and retain school-based mental health providers, such as social workers and counselors.

Another grant program would have fostered partnerships between universities and high-need school districts to train new mental health professionals. Funding would support developing curricula and providing students with pathways to state credentials. The legislation encouraged partnerships with Historically Black Colleges and Universities, Tribal Colleges and Universities, and other Minority-Serving Institutions to build a more diverse workforce.

Finally, the bill would have authorized grants to implement trauma-informed care and support services in schools and Head Start programs. These funds could be used for initiatives to create a stable learning environment and provide mental health services to students, families, and staff. The focus was on equipping institutions with financial resources to address student mental health challenges.