Mental Health Insurance Parity–Updated December 31, 2013

Action Items:

On  November 13, 2013, the Final Rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addcition Equity Act  of 2008 were issued by the Federal Government (the Department of the Treasury, the Department of Labor and the Department of Health and Human Services).  These rules will expressly rely on state insurance departments for enforcement.  Advocates are urged to contact Andrew Boron, the Director of the Illinois Department of Insurance and urge him to take steps to enforce insurance parity in Illinois.

Background

* Among the serious problems facing persons with mental illnesses in Illinois is the fact that health insurance companies have traditionally discriminated against them.  Frequently coverage for the treatment of mental illnesses has been substantially less generous than coverage for other medical conditions.  Among the ways that coverage has been restricted are:
o annual and lifetime limits on the number of days of inpatient care available to treat mental illnesses
o annual and lifetime limits on the number of outpatient visits available to treat mental illnesses
o higher deductible and copayment requirements
* More than thirty-five states have passed some form of mental health parity legislation designed to reduce or eliminate discrimination in health insurance coverage
* Recently the federal government enacted the Paul Wellstone Insurance Parity Act to reduce discrimination in health insurance coverage of mental illnesses.  Click here for more information about this important law. 
* After years of effort by mental health advocates, particularly Mental Health America of Illinois and NAMII-Illinois, we enacted our first parity law in2001.  215 ILCS 5/370c.  The law was quite weak.  Among its limitations were:
o a sunset provision
o application only to group health insurance polices, not Health Maintenance Organizations, individual policies or insurance provided by employers with fewer than 50 employees
o coverage for only nine mental illnesses.
* Subsequently, the Summit has succeeded in strengthening Illinois’ parity law by:
o Eliminating the sunset provision in 2005.
o Adding additional illnesses including post-traumatic stress disorder, anorexia and bulimia
o Increasing the number of outpatient visits
o Covering Health Maintenance Organization

* The main argument against mental health insurance parity laws has been that they will increase the cost of health insurance.  The argument is that this will hurt employers and, due to the increased costs, reduce the number of persons covered by health insurance.

* Because mental health parity laws have been enacted in so many jurisdictions and have been in place for many years, their effects have been well researched. This research has consistently found that cost increases have been small or non-existent.  That is because providing prompt mental health services, reduces the prevalence and severity of non-psychiatric illnesses.  For example, persons whose mental illnesses are not promptly treated often delay obtaining treatment for non-psychiatric illnesses until these illnesses become more serious and the costs of treatment higher.

 Click here for detailed information on the Wellstone-Domenici Parity Law

Parity” Toolkit, Parity Implementation Coaliton (October, 2010)

CMS website on the Federal MHPEA Act 

Summit Policy Position

The Mental Health Summit supports laws which prohibit any health insurance discrimination against persons with mental illnesses.  We support full parity

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