September marked the one-year anniversary of the historic collapse of the U.S. financial markets. We still vividly recall former Treasury Secretary Henry Paulson's passionate plea to Congress for nearly $1 trillion to bailout of the country's financial system as Lehman Brothers, Merrill Lynch, AIG and other financial firms imploded.

Although in the end, Paulson got what he asked for, within the financial bail-out legislation was the Mental Health Parity and Addiction Equity Act of 2008. Mental health parity is not new to benefits professionals. In 1996, a federal law made it illegal for employer-sponsored group health plans with 51 or more employees to impose a ceiling or benefits cap on mental health benefits if there was no such cap (or a higher cap) on covered medical and surgical benefits.

However, this mandate still allowed for some benefit controls, such as limiting the number of annual provider visits, providing flexibility on the amount of employee cost-sharing and not extending to treatment for substance abuse.

Advocates of the law complained that such allowances were loopholes, and last year's law closed them. Although the well-intended legislation is designed to ensure benefits equity for millions of Americans with behavioral or addiction-based illnesses, it limits the ability of health plans with mental health coverage to cap or limit benefits for mental health or substance abuse below what the plan covers for medical and/or surgical benefits.

Research shows that as many as 90% of health plans that offer mental health benefits do so with a cap or limitations. Yet, it's estimated that as many as 35 million Americans suffer from a mental illness or substance abuse condition in the United States each year.

So, plan sponsors must determine how to balance the requirements of the law with the costs of compliance in plan year 2010. The law gives benefits pros some wiggle room. First, nothing in the 2008 mental health parity law actually requires employers to offer mental health and substance abuse coverage as part of their health plan.

And for employers that don't drop coverage entirely, it offers an opportunity for exemption. In other words, plans that can prove a cost increase of more than 2% of their total plan cost of coverage as a result of this benefit expansion can claim an exemption from the mandate and either drop coverage entirely or return to their former host of benefits.

Of course, this exemption is only upon the receipt of proof of the cost increase by a certified actuary, and can only be claimed after offering the benefits as mandated for a period of no less than six months.

I will be watching my peers closely to compare costs increases and even to see if any of them contemplate dropping the coverage entirely. Perhaps this mandate will provide some insight as to how employers will react to the ultimate health care reform package that will come from the current administration. If given a choice, are we so tired of state and federal mandates that we will eliminate coverage entirely in silent protest? I predict that is unlikely.

Employers offer competitive benefits as a way to attract and retain the best talent available. And as for coverage for mental health and substance abuse, in a society where millions of Americans suffer, we could save a few premium dollars if we were to eliminate coverage. But wouldn't we see those dollars multiplied as our employees were left untreated?

I'm particularly interested in determining the outcome of the enhanced benefits. Will there be less time lost from work because the number of visits to a mental health or substance abuse provider is no longer capped and cost-sharing is on equal footing with medical and surgical benefits?

Will the millions of Americans afflicted with mental health and substance abuse disorders be reduced because of this expanded coverage? I've always believed in doing the right thing, simply because it's the right thing to do. But without measured outcomes, aren't we just encouraging more mandates?