What Mental Health Care Protections Exist in Your State?

Insurers have wide latitude on when and how they can deny mental health care. We looked at the laws in all 50 states and found that some are charting new paths to secure mental health care access.

Accessing mental health care in the U.S. can be exhausting — and often, it’s not the therapist or diagnosis that creates the biggest hurdle, but the insurance company. Even when patients find care within their network, insurers can override the provider’s judgment and deny treatment by claiming it’s not “medically necessary.” This loophole has allowed insurers to create internal rules that often prioritize cost over patient care.

Some states are pushing back. While federal law requires equal coverage for mental and physical health, it doesn’t require insurers to use evidence-based standards. That’s changing in a growing number of states, which are setting clear clinical criteria, regulating insurance reviews, and demanding transparency in access and reimbursement.

States like California, New York, and Oregon are leading the way — requiring insurers to follow accepted medical guidelines, limiting how and when they can audit treatment, and forcing them to report how accessible mental health care really is.