Our Health Policy Matters

One of the most controversial elements of bipartisan mental health reform bills in Congress is a surprising one. It’s an effort to amend a 45 year-old regulation that outlived its useful life twenty-five years ago when the Americans with Disabilities Act (ADA) was signed into law.  It is referred to in Washington as “42 CFR Part 2.”  You might know it as the rule that forces you to sign at least two authorizations, instead of one, just to get your own health records sent from one place to another. Today, if you sign an authorization stating “please share all of my health records and medical history with another provider,” you might think that second provider is going to get everything.  But 42 CFR says substance use disorder isn’t covered by that – for that, you need a second one. Keep in mind that in 1970, when 42 CFR was being considered, you could discriminate against someone with a substance use disorder.  You could even fire them from their job.  So there was a re