---
type: source
title: "Mental Health Parity Index National Launch: 43 States Show Structural Access Disparities Driven by Reimbursement Differential"
author: "Kennedy Forum + AMA + American Psychological Foundation + Ballmer Group"
url: https://www.ama-assn.org/public-health/behavioral-health/mental-health-parity-index
date: 2026-04-14
domain: health
secondary_domains: []
format: report
status: processed
processed_by: vida
processed_date: 2026-05-01
priority: high
tags: [mental-health-parity, MHPAEA, reimbursement-rates, network-adequacy, access-disparity, monitoring-infrastructure]
intake_tier: research-task
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

The Mental Health Parity Index launched nationally on April 14, 2026. Key findings:
- **43 states** have disparities in access to in-network mental health care and substance use disorder treatment relative to physical health care
- **7 in 10 counties** face similar access disparities locally
- When benchmarked to Medicare payment rates, the majority of clinicians providing MH/SUD treatment are paid LESS than clinicians providing physical health treatment — this differential is documented as a driver of lower in-network participation
- The Index was launched by The Kennedy Forum in collaboration with Third Horizon, AMA, American Psychological Foundation, and Ballmer Group
- **Illinois** was the first state to conduct a deep-dive analysis, piloting the Index after signing a mental health parity bill into law
- The tool visualizes how insurance contract data relate to access disparities at the county level, providing a measurement infrastructure for outcome-based parity monitoring

Additional AMA finding: new insurer data shows parity gaps in mental vs. physical health care. The Index helps insurers, employers, providers, consumers, and policymakers identify where access problems are greatest.

Sources confirmed in search: [AMA Mental Health Parity Index](https://www.ama-assn.org/public-health/behavioral-health/mental-health-parity-index), [Kennedy Forum Parity Index](https://www.thekennedyforum.org/focus-areas/coverage-parity/parity-index/), [APF Nationwide Launch](https://ampsychfdn.org/mhpi/), [TechTarget coverage](https://www.techtarget.com/healthcarepayers/news/366641686/Mental-health-parity-remains-elusive-in-43-states)

## Agent Notes

**Why this matters:** This is the first national tool that documents the REIMBURSEMENT DIFFERENTIAL (not just coverage design disparities) as the driver of the mental health access gap. Previous KB claims established the 27.1% reimbursement differential (RTI International 2024) conceptually; this Index operationalizes it at the state and county level using Medicare payment benchmarks. It creates the monitoring infrastructure that outcome-based enforcement would require.

**What surprised me:** The scale — 43/50 states with structural disparities — is broader than I expected. The previous KB narrative focused on the federal enforcement gap; the Index reveals that the problem is near-universal and structurally embedded in how commercial insurers price MH/SUD care relative to physical health.

**What I expected but didn't find:** I expected some states to show meaningful parity achievement. The 43-state finding suggests no state has effectively solved the reimbursement differential problem through current MHPAEA enforcement mechanisms — confirming the two-level access problem is structural, not enforcement-dependent.

**KB connections:** Directly enriches mental health supply gap is widening not closing because demand outpaces workforce growth and technology primarily serves the already-served rather than expanding access. The reimbursement differential mechanism connects to social isolation costs Medicare 7 billion annually..., the MHPAEA enforcement analysis from Sessions 31-32. New monitoring infrastructure is relevant to the question of whether outcome-based enforcement can address the two-level access problem.

**Extraction hints:**
1. Claim: "The Mental Health Parity Index documents that 43 states have structural access disparities in commercial insurance driven by below-Medicare reimbursement rates, not just coverage design failures"
2. Claim: "Reimbursement benchmarking tools are the necessary but missing infrastructure for outcome-based MHPAEA enforcement"
3. Possible enrichment of existing mental health supply gap claim with the 43/50 state evidence

**Context:** Launched April 14, 2026 — two weeks ago. Co-sponsored by Ballmer Group (Steve Ballmer's philanthropic focus on social/government data). This is politically significant — the Index was designed to give state regulators empirical ground to enforce parity independent of federal enforcement posture.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: mental health supply gap is widening not closing because demand outpaces workforce growth and technology primarily serves the already-served rather than expanding access
WHY ARCHIVED: First national tool documenting the reimbursement differential as structural driver of access disparities in 43 states — this is the missing measurement infrastructure for the two-level MHPAEA access problem identified in Sessions 31-32
EXTRACTION HINT: Focus on the reimbursement benchmarking finding (majority of MH/SUD clinicians paid below Medicare rates) as the mechanism connecting the Index to network opt-out. The 43-state finding is the headline but the reimbursement differential is the structural mechanism.
