Managed Care - April 2008 - (Page 14) Mental Health Parity At Long Last? A coalition of employers, legislators, consumer advocates, health plans, and drug companies may bring about equal coverage Un, MD, national medical director of Aetna Behavioral Health. “Parity is important. It is the right thing to do, to not discriminate against individuals with behavioral health issues. We want to make he health care industry and the American sure that the legislation does not have an uninpeople may be at a historic moment in the tended consequence of increasing barriers to care.” treatment of mental health and substance The difference between the two versions is inabuse. Congress is considering legislation dicative of the long-running controversy over what that would “completely end insurance discriminamental health parity should be and the debate over tion against mental health and substance use dishow it is best realized for people who need help. The order,” says the American Psychological Association. House version is more expansive, the Senate “It is easy to understand their enthusiversion more limited in scope — with a sigasm,” says Andrew Sperling, JD, director of nificantly greater chance of passage. federal legislative advocacy for the National The public need for some parity legislaAlliance on Mental Illness, a patient advotion is significant. The federal Substance cacy organization that is backing the legisAbuse and Mental Health Services Adminlation. “There hasn’t been this broad a coaliistration (SAMHSA) reports that “despite tion of support ever for any similar the impairment and distress resulting from legislation, and the president has said he fatheir illness, a large proportion of adults in vors the Senate bill. But it is far from over. the United States with mental health probAny single senator can block this.” “Lack of parity and lems delay treatment or do not receive treatSperling’s concern reflects the ability of barriers to quality ment for their mental disorders.” In 2003– any senator to block legislation through fil- behavioral health ibuster or other parliamentary rules, and it care can affect over- 2005, 11 million adults perceived an unmet recalls the adage attributed to Otto von Bis- all health costs,” says need for treatment or counseling for mental health problems in the past year. Of marck in the 19th century: “There are two Hyong Un, MD, of those, 48 percent reported cost or insurance things you don’t want to see being made — Aetna Behavioral Health. Parity would issues as a barrier to treatment. sausage and legislation.” even help plans betThe two bills do have much in common, As of press time, two versions of parity ter coordinate care. and if a compromise between the versions is legislation existed: a Senate version, loved reached and a federal parity standard is adopted this (or at least tolerated) by virtually everyone, even the year, it is fairly clear what it will contain: U.S. Chamber of Commerce and the National Association of Manufacturers, and a House version, • Health insurance plans, including employerunloved by almost everyone, even the National Alsponsored plans that function under federal liance on Mental Illness. law but are exempt from state insurance laws, “We want to see an agreement on legislation that are barred from charging different deductibles will be successful this year in coverage for equiand copayments for mental health and subtable treatment,” says Sperling. “The Senate bill was stance abuse services than they do for medical acceptable to all 100 senators.” benefits, but only if plans choose to offer men“We also prefer the Senate version,” says Hyong By Martin Sipkoff Contributing Editor T 14 MANAGED CARE / APRIL 2008 PHOTOGRAPH BY PETER HVIZDAK
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