Mental Health Parity: Are We There Yet?

Former Rep. Patrick Kennedy, Rep. Jan Schakowsky, and Rep. Mike Quigley held a public hearing this evening in Chicago, on the current state of the Domenici-Wellstone Mental Health Parity and Substance Abuse Equity Act, which President Obama signed into law over two years ago.

The hearing featured moving testimony from providers and consumers of mental health and substance abuse treatment services, as well as others involved in the effort to assure that people with mental illnesses and addictive disorders have access to the same levels of benefits through their insurance plans that they would have for any other health condition.

We heard from people whose lives may well have been saved because their health plans paid for the treatment they needed. We also heard from those who nearly lost their lives because of limits or denials of coverage. We learned how the problems of stigma, coverage limits, and lack of insurance impact many in our communities, including college students, military and veterans (especially those who can’t or won’t get help through the VA system), and those for whom jail has become the only treatment setting they can ever hope to see.

Dr. Joe Troiani, my colleague at the Adler School of Professional Psychology (and a veteran of the US Navy), spoke of the needs of veterans as well as the needs of community mental health providers who serve those who have no other treatment resources available – often with long waiting lists. We heard from those who struggle with health insurers on a daily basis, trying to obtain authorization for services that are arbitrarily denied as “not medically necessary,” with no transparency about the criteria for medical necessity used by the insurers.

Unfortunately, the federal rules that would specify how health plans must implement the parity law have still not been written by this Administration. Further, bringing many non-commercial health plan members (especially those on Medicaid) into the spirit of this legislation remain a huge challenge.

We heard how fortunate the mental health community was to have the equity law passed when it was, because it may not have survived if it were to be considered when combined with the Affordable Care Act. Although the ACA provides additional protection against lifetime coverage caps, insurers are still using denials and other means to limit payment for vital treatment and other cost-effective services like early intervention and independent care management.

Rep. Schakowsky concluded the evening by urging all the assembled stakeholders, and other advocates for the wider availability of treatment of addiction and mental illness, to mount an advocacy effort similar to the one that led to the defeat of the “Stop Online Piracy” bill. She said that people need to be as passionate about their affected family members, friends, and co-workers as online freedom advocates have been about their Internet access. Using social media may be the best way to raise public awareness and assure that health insurers consider the social return and contribution to the public good that is served by covering effective treatment on a continuing basis for these chronic health conditions, much as they have come to do for conditions like diabetes and heart disease. (This effort already has wide support from businesses who see the value in returning employees and family members to a better level functioning and well-being, as shown by a letter of support from the Chicagoland Chamber of Commerce).

Anyone who is interested in this effort can find out more by going to the website of the Parity Implementation Coalition at http://parityispersonal.org.

CC BY-ND 4.0 Mental Health Parity: Are We There Yet? by Fitzgerald Counseling is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.