If you're living with a chronic illness, you're in the right place.

Saturday, October 27, 2012

The Slow Road to Parity

5:54 AM Posted by Tiffany Taft , , , ,
If you've ever tried to use your health insurance for mental health services, you may have experienced some challenges.  Things like need for prior authorization to see a therapist, limits on the number of sessions you can have, or limits on the amount of coverage your plan allows (to name a few).  Starting in 1996, congress passed a law that aimed to create "parity," or equality, between coverage for mental health and physical health conditions.  This law stated that insurance companies cannot have different lifetime benefit limits for mental health care. It was a start; unfortunately it took 12 years for the issue to be revisited.

In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) was passed, adding to the 1996 law that health insurance issuers cannot require higher co-pays or deductibles, or restrict the number of treatment visits for mental health conditions.  So why are people still experiencing hurdles when it comes to using insurance for mental health services?  A rather long and convoluted 2012 report to congress on enforcement of the law is available.  It seems that regulators and agencies have had issues with enacting the law as its written, allowing coverage for mental health to remain unequal under many insurance plans.  "More studies are needed" to determine how to make these changes.

The Affordable Care Act aims to push the 1996 and 2008 laws even further by removing the pre-existing condition clauses that prevent many people with a mental illness diagnosis from using their benefits.  This move has been lauded by mental health organizations such as the American Psychiatric Association as a way to ensure proper treatments for the millions of people living with a mental illness. I'm also hopeful, but am also a bit of a cynic and just hope that loopholes aren't found and exploited, and implementation isn't tied up for years in committees of regulators who aren't sure how to make the necessary changes that are fair to all parties involved.

Depression is considered by the World Health Organization to be the world's leading cause of disability.  We know that up to half of people living with a chronic physical illness will experience some sort of anxiety or depression because of their illness.  Having access to quality medical and mental health care so the whole person, not just the diseased body part, is treated is essential.  We also know that mental health is directly correlated with physical health outcomes - people who feel better mentally are more likely to follow their treatment regimen, use the healthcare system less, experience less physical pain, and are more engaged in their pre-illness social and work roles.  It seems like a no-brainer to integrate (and pay for) mental health services as part of a comprehensive treatment of physical illness.

We will be watching how these laws play out, and remain hopeful that one day our mental well-being will be considered and appreciated equally.