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Thursday, May 20, 2010

Mental health in the new law

Erin Kelly

Staff Writer

People suffering from mental illnesses need access to appropriate medications and the right providers so that they can live productive and fulfilling lives. However, insurance companies have traditionally discriminated against individuals who need mental health services by placing more restrictive barriers—like higher co-pays or lower limits on hospital stays—on mental health services than on medical or surgical services. Some insurance companies have even required that people meet a separate deductible for mental health services, which creates a potentially insurmountable financial barrier to affordable care. These barriers have caused many to delay mental health services or even forgo them altogether.

In March, the Washington Post ran an article about Denise Camp, a woman with severe depression who was affected by this double standard:

While visits to her internist for physical problems required a $20 co-pay, her weekly therapy sessions with a social worker cost $50 and trips to the psychiatrist who prescribed her medication were $75.

With insurance covering a large share of her cost to see the internist, she had no problem paying the modest co-pay. But since her insurance didn’t cover as much for mental health visits, she had to fork over a larger chunk of money, which was difficult on her low-income salary. She chose to skimp in other places so she could afford mental health services, but others who don’t have that choice are forced to forgo necessary treatment.

Advocacy groups have been fighting for improved access to mental health services for decades. Thankfully for Americans in need, help has arrived. The Mental Health Parity and Addiction Equity Act of 2008, which Congress passed to guarantee “parity”—a fancy word for equality in access to care—to people in large group insurance plans, is now in effect. The Washington Post writes,

Higher deductibles, steeper co-pays and other restrictions are no longer allowed for mental health and substance abuse treatment.

As a result, people in large group plans who have had to pay two deductibles—one for mental health services and one for medical and surgical services—will only have one deductible, which will make care much more accessible to them.

Unfortunately, some managed care companies are fighting back against the regulations for implementing the new law, telling the Department of Labor that it will cost them too much to combine deductibles for mental health and medical or surgical services. While some companies may face a one-time cost to combine deductibles for people in their plans, without this step, consumers would continue to incur disparate, unaffordable, and unfair costs. Therefore, the Department of Labor’s regulations must be protected. Americans in need of mental health services simply can’t afford this kind of discrimination.

If you’d like to know more about the new law and why Families USA supports the measures, click here to read our letter to the Department of Labor and the other agencies overseeing the law.