You may have missed #22 of  the 23 executive orders President Obama signed as part of his gun control package. It’s the second to last paragraph on the last page of his plan.

• Finalize requirements for private health insurance plans to cover mental health services: The Administration will issue final regulations governing how existing group health plans that offer mental health services must cover them at parity under the Mental Health Parity and Addiction Equity Act of 2008. In addition, the Affordable Care Act requires all new small group and individual plans to cover ten essential health benefit categories, including mental health and substance abuse services. The Administration intends to issue next month the final rule defining these essential health benefits and implementing requirements for these plans to cover mental health benefits at parity with medical and surgical benefits.

Finally, the President of the United States says he “intends” to draft rules to implement our 4-year-old mental health parity law. It’s not a promise but after four years of the administration failing to take action on the rules, I’ll take an “intends.”

What this means is that next month – February – we are finally going to see how the government will make sure that insurance companies provide the same level of care for mental illnesses as they do for physical illnesses. That means co-pays, deductibles, hospital stays, preventive care all must be equal to coverage for physical illnesses. Draft rules will be published in the Federal Register, followed by a public comment period and then issuance of the final rules.

Insurance companies don’t want these rules. As long as there are no rules, they can play their game, their way. No referees, no fouls, no penalties. That’s the way it’s been since the law was passed four years ago.

I have been writing about parity for five years. Maybe more. In the words of former Congressman Patrick Kennedy, son of the late Sen. Ted Kennedy, mental health parity is the greatest civil rights health issue of our time.

The insurance industry’s discrimination against the mentally ill became so endemic that we stopped questioning why we had to pay higher co-pays for our anti-depressants or why office visits to a mental health provider were higher than our family doctor or why coverage for hospital stays relating to mental illnesses  was less than for physical illnesses. It’s just the way it was and we accepted it.

The insurance companies perpetuated and institutionalized stigma with these disparate practices. And finally, after 12 years of butting his head against the insurance industry’s lobby, Kennedy – with the help of his father and former Rep. Jim Ramstad of Minnesota, the parity law passed in 2008. (They tacked it on as an amendment to the must-pass Wall Street bail out bill just before the final vote.)

That should have been the end of the story.  Rules should have been drafted and we all should have all lived happily ever after with our mental health care needs covered as well as our physical health. That didn’t happen.

Kennedy and Ramstad retired but stuck with the cause. Last year they toured the country holding parity public hearings, where they heard countless stories of parity violations. I attended their hearing in Delray Beach, Florida. Also there was my local Congressman, Ted Deutch, who has been waging his own battles for mental health care reform.

On Jan. 3, Deutch sent a letter to the secretaries of Health and Human Services, Labor and Treasury urging for final implementation rules for the parity law. Deutch was one of the few lawmakers who made the connection between the Newtown shooting and improving mental health care by implementing parity

I called Deutch to get his thoughts on #22.

“This isn’t some dry bureaucratic exercise to get something published in the Federal Register,” Deutch said about the parity rules.

“There’s going to be discussion following Newtown about mental illness. Helping people realize mental health is as important as physical health – the two can’t be viewed separately,” Deutch said. “That’s going to be a really important discussion.”

“If we can accomplish two things – helping people to engage in discussion and recognize that they or their loved ones may need to get help for a mental illness and then ensure access is available, then we’re taking tremendous step forward.”

It’s about time.

Click below to read my other blogs on parity

Mental health insurance parity v the insurance industry: Who’s winning?

Insurance Parity: So close, and yet so far

Rant-o-Rama: Blue Cross’ end run around the mental health parity law

Ranto-o-Rama: Mental health parity for 9/11 survivors

Got depression: Separate deductibles are good for you! Really