Parity Progress 

Mental health insurance legislation on the horizon

After several bites at the legislative apple, proponents of insurance parity for the mentally ill now see possibilities for success in this year's session.

Ten years ago, Congress passed the Mental Health Parity Act, making it illegal for companies with more than 50 employees to set dollar insurance limits for mental health care. Despite opposition from insurance companies and then-president George H.W. Bush, the law has received annual reauthorization, albeit with no changes or additions. The current administration has supported making the program permanent as it applies to federal employees, and a majority of states have now taken their lead from Washington. Yet in many of them, adults diagnosed with multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, substance abuse disorders, and children with serious emotional disturbances and substance abuse problems still, find themselves excluded from lower-cost coverage.

According to the National Institute of Mental Health, Idaho ranks 48th nationally in per capita spending on mental health, yet the state remains among the 16 in which insurance companies may charge up to 80 percent higher premiums for psychological conditions, as well as higher co-payments and deductibles, and fewer outpatient visits. With some prescription psychotropic medications costing hundreds of dollars per month, families with members suffering from mental illnesses find themselves hard-pressed to cover both drugs and the other necessities of life.

Despite scattered legislative support, mental health advocates' efforts to bring parity to Idaho have been frustrated over recent legislative sessions. Last year, representatives Kathie Garrett (R-Boise) and Margaret Henbest (D-Boise) supported H.B. 286, designed to set up a pilot program for state employees and their family members. A centerpiece of that bill would have required cost-monitoring, with the expectation that state expenditures for substance abuse, law enforcement and corrections would fall as well. H.B. 286 died on the floor by a vote of 39 to 31.

Garrett attributes the defeat to resistance by private insurance companies fearing increased payouts, but she told BW she is planning to introduce a new version, and she is optimistic that the addition of a sunset clause and cost tracking would make it more palatable this time around. Garrett is also working on getting people living with mental illnesses to testify to her committee, rather than simply service providers. "But it's always a challenge. I don't know if we'll ever get past the problem of stigma that we've created after years of misunderstanding. We need to hand that back to the community."

Representative Nicole LeFavour (D-Boise) agrees that the debate over parity isn't dead yet. "Issues come in cycles, and then we come to a crisis point where people come to understand," she told BW. "If we can act in that window, we'll have the votes." She states that "several people" who voted against parity last year have assured her support if a bill is presented again. "Maybe at that point, we'll know that the costs to society of not covering these illnesses is too great."

LeFavour urges members of the public to contact their legislators in order to affirm their support for such legislation.

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