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October 11, 2007
Mental health parity bill heard
Patrick wants passage, legislators are told
By Lee Hammel TELEGRAM & GAZETTE STAFF
Worcester Telegram and Bazette
BOSTON— Mental health parity would become a reality, and not
just the name of a political compromise, if the state Legislature
passes a bill that got a hearing yesterday before the joint Committee
on Mental Health and Substance Abuse.
Six years ago, legislators passed a mental health parity law
amid general congratulation that discrimination in coverage would end
because insurers who offered mental health coverage were required to
make it equal to the insurance they offered for other illnesses.
To get the bill through a contentious legislative process,
advocates had to agree to exclude mental illnesses in adults not
considered biological in nature. So, while nine classes of major mental
illnesses, such as schizophrenia and depression, were included,
disorders such as post-traumatic stress disorder, eating disorders and
substance abuse were not included.
Yesterday, state Rep. Ruth B. Balser, D-Newton, the committee’s
co-chairwoman and a clinical psychologist, said that is a political,
not a scientific, distinction. She said research shows a biological
connection for even those disorders, and that battered wives and
stressed war veterans need treatment in any event.
Gov. Deval L. Patrick supports the bill, state Department of
Mental Health Commissioner Barbara Leadholm testified. She said that
mental illness causes more absenteeism and lost productivity than many
other chronic conditions, such as diabetes, asthma and arthritis.
Former Gov. Michael S. Dukakis and his wife, Kitty Dukakis,
who has written about her bouts of substance abuse and mental illness,
were on hand at a press conference and testified during the hearing.
The former governor said that dozens of evaluations of state
and federal insurance policies that include mental health parity have
shown no significant increase in costs.
“If managed properly, they do go down dramatically,” Mr.
Dukakis said, because treatment is received earlier when it is more
effective and less expensive.
When limits on mental health and substance abuse services were
eliminated from federal employee health insurance, 1.35 percent to 2.75
percent more people used mental health services, according to former
DMH Commissioner Marylou Sudders. Spending, however, did not increase,
a study in the New England Journal of Medicine showed.
The bill in the state Legislature comes on the heels of the
U.S. Senate’s unanimous passage of a mental health parity law on Sept.
18. The federal bill, awaiting House action, would regulate the
self-funded insurance plans of companies with more than 50 employees —
estimated to affect about 60 percent of the insurance plans in
Massachusetts.
The state regulates smaller insurance plans, including those
mandated by a recent state law requiring all residents to have medical
insurance.
The committee heard from people with mental illness and from
family members who said they have been exhausted dealing with insurance
companies that they say take advantage of the murkiness of the law to
deny benefits.
Paul Kusiak of Beverly said he was turned down by “a
psychiatrist in Texas who never saw our son” for payment of $14,000 in
treatment bills for his crack-addicted son.
After losing multiple appeals on bills that he said the
insurance company knew it was responsible for, Mr. Kusiak said he
threatened to report the company to the state Legislature and expose it
in the press.
The company called him back and approved the payment within minutes, he said.
Ann Rudy of Roslindale, who has bipolar illness and recently
graduated from law school, told the committee that passage of the
original bill in 2000 made her believe that “really, I matter.”
“You have the power to give so many people a full life,” she testified.
While no one testified against the bill yesterday, the
Massachusetts Association of Health Plans released a statement opposing
the bill, saying that it would lead to “significant increases in the
cost of health.”
Because it mandates coverage of any disorder listed by the
American Psychiatric Association, “This mandate opens the door to
requiring coverage for diagnoses that are not appropriately treated in
the behavioral health setting and would require coverage of
‘non-medical’ services as part of medical coverage,” MAHP said.
Susan Fendell of Mental Health Legal Advisers Committee thinks the bill does not go far enough.
Calling the present system inhumane, the MHLAC’s senior lawyer
wants mandated coverage extended to age 25, not age 21 as the bill
proposes.
She also said the system can be circumvented unless health
care providers, not insurance companies, determine what is “medically
necessary.”
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