A new report out today from the National Alliance for Mental Illness says the health insurance industry discriminates against the mentally ill. That’s in spite of a 2008 federal law, requiring insurers to provide the same level of coverage for the mentally ill. And the Affordable Care Act hasn’t helped either.

One big issue the report cites is a shortage of providers.

“When people are seeking mental health care they may have a real problem finding it,” says Ron Honberg, director of policy and legal affairs for NAMI. And even if patients are able to find psychiatrists they may not be able to afford treatment.

“People are being denied requests for mental health care at levels more than twice those of denials for physical health care,” he says.

Honberg notes that the criteria for how insurers decide what gets covered and what doesn’t isn’t published—One of the many issues he says that needs to be addressed.