If you need a therapist and you’re covered by a plan on anAffordable Care Act marketplace, you may have a tough time findingone — because there just aren’t many there. The averageprovider network offers insureds access to just 11 percent of allthe mental health care providers in a given market, according to Kaiser Health News, reporting on arecent Health Affairs study. The study examined 2016 data for531 provider networks offered by 281 insurance carriers in themarketplaces in every state as well as the District of Columbiausing data from the Robert Wood Johnson Foundation.

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The study also finds that an average marketplace plan’s networkincludes just under a quarter of all psychiatrists and 10 percentof all nonphysician mental health care providers. Nonphysicianmental health care providers, it adds, include psychologists, nursepractitioners and physician assistants, and behavioral specialists,counselors and therapists with master’s or doctoral degrees.

But even if consumers wanted more, they likely wouldn’t have asmany as there are — because researchers also report that fewer thanhalf of all psychiatrists and a fifth of nonphysician providersparticipated in any marketplace plan.

Kaiser says that the Mental Health Parity and Addiction Equity Act of 2008requires that health plans’ mental health services be at least asgenerous as medical/surgical services. But while that providesfinancial protection for consumers, access to in-network providersis still problem.

While the problem exists for more plans than those on the ACAmarketplaces, the study finds that high demand for services, ashortage of practitioners and low insurance reimbursement rateshave all contributed to an atmosphere on provider networks thatmake mental health care providers reluctant to join.

And while narrow networks, those that usually have less than 25percent of participating doctors and other health providers in thearea, have been adopted by many insurers to help keep marketplaceplan premiums lower, they can make the problem of finding mentalhealth services even bigger.

The study also analyzed the average network participation ofprimary care providers in marketplace plans to compare with theparticipation of mental health care providers. It found that theaverage network for ACA plans included 24 percent of all primarycare providers in a given market, more than twice the proportion ofmental health care providers.