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Psychotherapy, especially dynamic psychotherapy and psychoanalysis, has been poorly supported by insurance although the Mental Health Parity Act mandates benefits for mental health care at parity with other health care and The Affordable Care Act lists mental health care, including psychotherapy, as an Essential Health Benefit. Limiting insurance support for psychotherapy turns away very ill, especially poorer patients who forego treatment and incur increased medical costs and disability. Patients with personality disorders, chronic anxiety depression, chronic illness and comorbidity require extended, often intensive, psychotherapy for optimal recovery. Brief cognitive-behavioral therapy is seen as a “gold standard” and “most evidence-based” although its research protocols study subjects not typical of most patients and who achieve only short-lived improvements. Research finds psychodynamic therapies to be highly cost-effective, equal to other efficacious therapies in improving symptoms, and also superior in improving maladaptive interpersonal relationship patterns, a high-risk factor for mortality. Knowledgeable attorneys and expert witnesses were key to the 2019 successful class action lawsuit against United Behavioral Health for declining to cover research supported generally accepted standards for mental health care and for a subsequent California state law mandating sufficient insurance coverage. To defend it in legal and policy arenas, providers and advocates for psychodynamic psychotherapy should familiarize themselves with its supporting research and the laws that demand its provision.