Mental health parity & insurance mandates

Last week, Congress got a step closer to passing a Mental Health Parity bill after years of debating the issue. The bill would require insurance companies to provide the same coverage for physical and mental ailments.

For more than a decade, both houses have passed different versions of the legislation only to see it fall apart at the end. The biggest hiccup now seems to be that the bill doesn’t specify which mental disorders it will include.

The unintended consequences of fully covering services for autism, schizophrenia, bipolar and other mental disorders would be a skyrocket in the price of insurance premiums. That’s what critics warn.

Patient advocates argue that mental illness is as real as physical illness. Bipolar disorder is no different than diabetes in terms of its need for chronic, close management. So why should people with a mental disorder be discriminated against and forced to bear a heavier financial burden, which could derail any possibility of them leading a healthy and happy life?

Last week, Harvard Pilgrim CEO Charlie Baker started a great discussion
on THCB about mandates with a post on Massachusetts’ move to be the first state to
mandate all insurance plans to offer prescription drug coverage. He
cited a study that showed average premiums would increase up to 30 percent, when the law takes effect in January.

The comments section was filled with provoking comments, including Eric Siegelman’s, which said: "I hope we can all agree mandating benefits adds to costs. The question
is, when a benefit is mandated is it benefiting the majority."

So does a national mandate to cover mental health care benefit the
majority? Is the expected increased cost worth the anticipated benefits?

If you’ve ever had a loved one suffer from mental illness and need
help, this is a no-brainer. If you haven’t seen someone struggle to
get help for a mental illness either due to a lack of coverage or available services, you’re either very blessed or probably
don’t know your family and friends well enough.

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2 replies »

  1. Deron, I think you raise a valid question. It is a slippery slope and perhaps a blanket mandate doesn’t address that issue without naming disorders. I didn’t mean to imply the critics’ arguments are invalid. To your question directly, I would pose another question. How do you distinguish between someone who has joint pain severe enough to warrant surgery and someone who doesn’t? Even though it’s a physical problem, it’s subjective and depends on the patient and treating physician. Even if depression is overdiagnosed, treating mild cases isn’t going to break anyone’s bank. And I think we can agree that few people are going to seek out the severe and intensive psychiatric services, which are most costly, unless they really need them.

  2. I have mixed feelings about this issue. Mental illness is every bit as real as physical illness, when the mental illness is real. How do you distinguish someone with real depression from someone who is down on their luck that diagnoses themselves as depressed and in need of care? I truly am not trying to be cruel. I just think this one’s a slippery slope.

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