Monday, February 21, 2000
Bill would give parity to mental disorders
Insurers couldn't limit coverage
BY SUSAN VELA
The Cincinnati Enquirer
For many years asthma, diabetes, heart problems and a massive depression disorder have plagued Crescent Springs resident Mary Johnson.
Ms. Johnson, a former bill collector now on disability, says that her health insurance has always taken care of her physical problems, but it has always left her mental health needs unmet.
Because her policy puts a yearly limit on mental health visits, she has gone months without seeing her psychologist. During those times, her depression spiraled, leaving her unwilling to leave her bed and house, and more likely to have panic attacks and psychotic episodes.
“There are some of us (who) can't snap out of it. People need to see the doctor but don't,” said Ms. Johnson, who has been diagnosed with a chemical imbalance.
She and others who suffer mental ailments claim that insurance companies discriminate against them by not providing equal coverage and limitations on their treatment compared to the coverage and limits on treatment for physical maladies.
These patients and their family members have joined mental health officials in lobbying Kentucky legislators to follow the lead of about 30 other states that have laws providing parity for mental health and substance abuse coverage on par with other health insurance benefits.
That means that patients would experience the same deductibles, co-payments, annual benefit maximums and limits on the number of office visits, regardless of whether the illness is physical or mental.
The so-called “parity” bill pending in Kentucky would only affect insurance policies that already provide mental health and substance abuse services. And it would exempt companies with 50 employees or fewer.
Supporters believe that House Bill 268 would increase early detection of depression, help more people remain functional and perhaps decrease the incidence of workplace violence. They note that 25 to 50 percent of physical disorders, including common headaches and insomnia attacks, have a mental health component.
“A lot of policies have mental health coverage, but it usually is very limiting. It's just treated differently,” said David Olds, director of the Covington-based Mental Health Association of Northern Kentucky.
The new bill is in the House Appropriations & Revenue Committee. It already has been approved by the House's Health & Welfare Committee.
Supporters predict that health insurers would see costs increase by merely 0.5 to 1.3 percent if the bill is improved. But a lobbying group representing Kentucky's health insurance carriers, including CHA Health and Anthem Blue Cross and Blue Shield, said the cost would be much more.
So high, one official said, that the new bill could cause some health insurers to drop all mental health and substance abuse services.
“Our concern is the way the bill is written,” said Melodie Doom-Shrader, director of the Kentucky Association of Health Plans.
“In the market today, everything is cost sensitive. (This) could be the straw that breaks the camel's back. We can't afford any more increases.”
People like Florence Edwards, of Highland Heights, said they already are near their financial breaking points. Ms. Edwards' 33-year-old daughter, Terri, cannot afford her meager mental health coverage. Terri, a former hospital employee, has been suffering from mental illness for several years and lives at home.
Terri's health insurance picked up the tab for 20 inpatient and 30 outpatient visits a year. That was fine until last year, when she was admitted into a mental health facility for a total of 42 days.
Mrs. Edwards said her daughter has thousands of dollars in unpaid medical bills. She is bothered by the fact that patients diagnosed with cancer and heart disease never have to worry about limits on the number of doctor's visits, but her daughter does.
“It's not fair,” Mrs. Edwards said. “We're paying the same premium those people are paying.”
Members of the Kentucky Mental Health Association began working on the pending legislation about a year ago. State Rep. Bob Damron, D-Nicholasville, chose to sponsor the bill because of his interest in mental illness and mental retardation.
“I always had a strong belief that government's role is to help those who really can't help themselves,” Mr. Damron said. “It's just the right thing to do.”
State Rep. Jim Callahan, D-Wilders, is one of about 20 co-sponsors. He could not be reached for comment.
Indiana already has approved a parity bill. There is similar legislation pending in Ohio's House of Representatives.
States began approving such legislation several years ago. Minnesota was one of the first to pass such a law in 1995. Mental health officials there believe the program has been successful.
Bill Conley, the Minnesota lobbyist who helped push the legislation through, noted that health insurance representatives recently reported to Minnesota legislators that premiums are skyrocketing by up to 20 percent. But they did not give parity as one of the reasons, he noted.
But Mark Kulda, a lobbyist for Minnesota health insurers, noted that parity certainly has been a factor. He and others, though, agree that it's been difficult to gauge how much the cost has amounted to.
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