|
|
| From February 2000 NASW NEWS Copyright ©2000, National Association of Social Workers, Inc. |
Mental health coverage parity was a major issue for states in 1999.
While most of the parity laws on the books in 27 states remain limited, studies are showing that parity does not increase costs.
Many of the state laws include limitations on the mental illnesses covered, contain cost-increase caps or provide exclusions based on factors such as the number of employees in a workplace.
Only five state parity laws include substance abuse treatment coverage.
Still, evidence is deflating the chief myth that has led insurance companies and business to resist parity at both the state and federal levels.
"More studies are coming out saying it's not more expensive — less than a 1 percent increase — to offer mental health coverage," said Nancy Bateman, NASW senior staff associate.
"What we have noticed is, it has not increased private insurance premiums substantially," said Al Guida, vice president of government affairs for the National Mental Health Association, which agrees with NASW that most limited-parity laws, like the federal Mental Health Parity Act of 1996, "have 'disadvantaged' the social work profession."
Limited-parity laws — including those passed last year in California, New Jersey, Virginia, Hawaii and Montana — offer mental health coverage parity with physical health coverage only for serious mental illnesses. Treatments for most such illnesses are likely to be under the jurisdiction of psychiatrists, not social workers.
The federal parity act applies only to workplaces with more than 50 employees and does not address substance abuse treatment, limits on length of stay or number of visits, or discriminatory deductibles and copayments. In addition, plans that don't already offer mental health coverage are not bound by its provisions.
Several bills in Congress in late 1999 addressed one or more of the act's limitations, but none was passed.
Many state lawmakers have taken it upon themselves to try to strengthen laws locally, with a goal of creating full and comprehensive parity, including parity for substance abuse coverage. So far, only Maryland in 1994, Minnesota in 1995, Vermont in 1997 and Connecticut in 1999 have achieved that.
The Connecticut law's passage was preceded by four years of work, noted Stephen Karp, former executive director of NASW's Connecticut Chapter and now director of chapter services and continuing education at the national office.
Connecticut was among almost a dozen states that passed some sort of mental health parity legislation in 1999.
Nebraska enacted a limited-parity bill requiring companies that choose to cover mental illness in their plans and have at least 15 employees to apply the same coverage caps and limits to serious mental illnesses as those used for physical illness.
Indiana enacted a bill last year that includes all mental illnesses, but does not include substance abuse and exempts firms with fewer than 50 employees.
In some other states, the outcome was less favorable. New Mexico's legislature passed a parity bill during the 1998-99 session, but the governor vetoed it, said director Pat Tyrell. In Illinois, an NASW-supported bill passed twice in the House but failed to clear the Senate.
Bateman and Guida said that politics and special interests of the insurance companies and employers play a big role in the outcome of the parity debates at both state and federal levels. Both see the quest to add parity for substance abuse coverage in all plans as the biggest challenge in the future.
"There no justifiable scientific reason for excluding substance abuse from any parity legislation," Guida said. "It's all politics."
Back to NASW News Contents
|
Copyright NASW Press, 1998 |
