Mental-health patients likely to get equal health insurance coverage
After eight years of futility, advocates for the mentally ill are primed to finally get equal treatment from health insurance.
So-called mental-health parity is on a fast track in the Democrat-controlled state Legislature, with a vote scheduled for today in the House. Gov. Christine Gregoire has indicated her support. Even opponents are resigned to the law's eventual enactment.
The premise is simple: Psychiatric disorders should be covered by insurance at the same level as physical ailments, with no special caps or extra co-payments. At least 35 other states — as politically disparate as California and Mississippi — already have versions. However, exemptions to the measure could limit who benefits.
The Office of the Insurance Commissioner was unsure yesterday how many people would be covered. But mental-health coverage would be assured for 300,000 public employees, and nearly 100,000 low-income people on the Basic Health Plan, raising state health-care costs by about $2.5 million a year.
Not included under the legislation would be insurance plans for businesses with 50 or fewer employees; self-insured companies, such as Boeing and Microsoft; and plans purchased by individuals. Substance-abuse treatment, marital counseling and residential treatment also would not be covered by the measure.
Federal employees already get parity for mental-health care through a 1996 bill signed by President Clinton.
Health insurers and business groups have fought the state bill with arguments that it would raise premiums for private employers across the state up to 5 percent, and would lengthen the 47-item list of treatments mandated for coverage.
But supporters, including Sen. Karen Keiser, chairwoman of the Senate Health and Long-term Care Committee, dispute such predictions, and argue the impact would be minimal compared with the human toll of untreated illness. The measure, Keiser said, would help her niece, who is mentally ill and has bounced from emergency room to emergency room.
"Every time someone goes through a crisis, they lose a little bit of their soul," said Keiser, D-Kent. "They never come back all the way."
The bill to be voted on in the House today, HB 1154, would phase in from 2006 to 2010 a mandate that psychiatric treatment be covered at the same level as
medical and surgical treatments.
The Association of Washington Health Care Plans, which includes the state's 10 largest insurers, estimates mental-health parity would boost premiums 4 to 5 percent in plans that currently have no mental-health coverage. For plans with some mental-health coverage, the increase would be about 1 percent, said Sydney Smith Zvara, the association's director.
It would be tough for some employers to absorb higher insurance costs after three years of double-digit increases, she said. "On top of the already existing mandates, our purchasers are saying 'enough already,' " she said. "Anytime we add on a mandate, there are employer groups who say they can't provide it and will drop coverage."
Jon Bridge, co-CEO of Ben Bridge Jeweler, voluntarily began offering his 800 employees mental-health parity more than 10 years ago. "It hasn't added any extra costs that I can tell," he said. "It isn't used a lot, but it was something we felt should be provided if you are going to provide medical care."
Mental-health parity has been considered but rejected by the Legislature each session since 1998 because of the stigma attached to mental illness and misperceptions about costs, said Randy Revelle, chair of the Washington Coalition for Insurance Parity.
"There has been a revolution over the last 10 to 15 years in terms of treatment and our ability to manage the costs of mental illness," said Revelle, a former King County executive who has publicly described his own struggle with bipolar disorder.
Almost all insurance plans offered in the state discriminate against the mentally ill, he said, by requiring higher co-pays or allowing fewer days in the hospital than for physical disorders.
Offering parity is sound fiscal policy, Revelle said, citing higher worker productivity and reduced costs of incarceration and emergency care.
Ree Sailors, Gregoire's health-policy adviser, agrees. She cites a study of Fortune 500 companies that links mental-health coverage to fewer employee sick days.
"It's enlightened," she said. "If Fortune 500 companies say we put this in and it's saving us, why wouldn't we want to do it too?
"But the other side is we're in a hell of a mess with revenues and demands," she said. "It's a gruesome task to deal with this $1.8 billion [budget] shortfall."
The bill being voted on today in the House zipped through the Financial Institutions and Insurance Committee nine days after it was introduced. It is scheduled for a hearing in a Senate committee in mid-February.
Mellani McAleenan, of the Association of Washington Business, which opposes the bill, hopes to slow the process by focusing on the financial cost of parity rather than personal anecdotes.
"When you feel so emotional about something, you may not be swayed by the facts and figures," she said. "That's tough, but that's a position we definitely find ourselves in."
Keiser said the bill was not a "slam-dunk" in the Senate, but it has broad support in the Democrat majority. "People down here know how to count heads," she said. "I think it has the best chance ever."
So-called mental-health parity is on a fast track in the Democrat-controlled state Legislature, with a vote scheduled for today in the House. Gov. Christine Gregoire has indicated her support. Even opponents are resigned to the law's eventual enactment.
The premise is simple: Psychiatric disorders should be covered by insurance at the same level as physical ailments, with no special caps or extra co-payments. At least 35 other states — as politically disparate as California and Mississippi — already have versions. However, exemptions to the measure could limit who benefits.
The Office of the Insurance Commissioner was unsure yesterday how many people would be covered. But mental-health coverage would be assured for 300,000 public employees, and nearly 100,000 low-income people on the Basic Health Plan, raising state health-care costs by about $2.5 million a year.
Not included under the legislation would be insurance plans for businesses with 50 or fewer employees; self-insured companies, such as Boeing and Microsoft; and plans purchased by individuals. Substance-abuse treatment, marital counseling and residential treatment also would not be covered by the measure.
Federal employees already get parity for mental-health care through a 1996 bill signed by President Clinton.
Health insurers and business groups have fought the state bill with arguments that it would raise premiums for private employers across the state up to 5 percent, and would lengthen the 47-item list of treatments mandated for coverage.
But supporters, including Sen. Karen Keiser, chairwoman of the Senate Health and Long-term Care Committee, dispute such predictions, and argue the impact would be minimal compared with the human toll of untreated illness. The measure, Keiser said, would help her niece, who is mentally ill and has bounced from emergency room to emergency room.
"Every time someone goes through a crisis, they lose a little bit of their soul," said Keiser, D-Kent. "They never come back all the way."
The bill to be voted on in the House today, HB 1154, would phase in from 2006 to 2010 a mandate that psychiatric treatment be covered at the same level as
medical and surgical treatments.
The Association of Washington Health Care Plans, which includes the state's 10 largest insurers, estimates mental-health parity would boost premiums 4 to 5 percent in plans that currently have no mental-health coverage. For plans with some mental-health coverage, the increase would be about 1 percent, said Sydney Smith Zvara, the association's director.
It would be tough for some employers to absorb higher insurance costs after three years of double-digit increases, she said. "On top of the already existing mandates, our purchasers are saying 'enough already,' " she said. "Anytime we add on a mandate, there are employer groups who say they can't provide it and will drop coverage."
Jon Bridge, co-CEO of Ben Bridge Jeweler, voluntarily began offering his 800 employees mental-health parity more than 10 years ago. "It hasn't added any extra costs that I can tell," he said. "It isn't used a lot, but it was something we felt should be provided if you are going to provide medical care."
Mental-health parity has been considered but rejected by the Legislature each session since 1998 because of the stigma attached to mental illness and misperceptions about costs, said Randy Revelle, chair of the Washington Coalition for Insurance Parity.
"There has been a revolution over the last 10 to 15 years in terms of treatment and our ability to manage the costs of mental illness," said Revelle, a former King County executive who has publicly described his own struggle with bipolar disorder.
Almost all insurance plans offered in the state discriminate against the mentally ill, he said, by requiring higher co-pays or allowing fewer days in the hospital than for physical disorders.
Offering parity is sound fiscal policy, Revelle said, citing higher worker productivity and reduced costs of incarceration and emergency care.
Ree Sailors, Gregoire's health-policy adviser, agrees. She cites a study of Fortune 500 companies that links mental-health coverage to fewer employee sick days.
"It's enlightened," she said. "If Fortune 500 companies say we put this in and it's saving us, why wouldn't we want to do it too?
"But the other side is we're in a hell of a mess with revenues and demands," she said. "It's a gruesome task to deal with this $1.8 billion [budget] shortfall."
The bill being voted on today in the House zipped through the Financial Institutions and Insurance Committee nine days after it was introduced. It is scheduled for a hearing in a Senate committee in mid-February.
Mellani McAleenan, of the Association of Washington Business, which opposes the bill, hopes to slow the process by focusing on the financial cost of parity rather than personal anecdotes.
"When you feel so emotional about something, you may not be swayed by the facts and figures," she said. "That's tough, but that's a position we definitely find ourselves in."
Keiser said the bill was not a "slam-dunk" in the Senate, but it has broad support in the Democrat majority. "People down here know how to count heads," she said. "I think it has the best chance ever."
posted by The Kid at 2:16 PM
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