The Benefits - 1
Mental Health Care as A Smart Investment
Many mental health professionals argue that failing to provide adequate mental health services carries tremendous costs for insurance companies and society as a whole. The American Journal of Psychiatry estimates that serious mental illness costs America $193.2 billion in lost earnings per year.
“Mental health coverage reduces costs. It’s not rocket science,” says Dr. Ann Becker-Schutte, a psychologist in Kansas City, Mo., who specializes in treating patients coping with serious medical conditions. Becker-Schutte, whose blog can be found here, cited a study showing that depression is associated with poor diet and medication regimen adherence, which in turn result in higher health care costs.
While Becker-Schutte is in private practice, mental health professionals who work in hospitals witness the waste associated with denying access to therapy and medication on a grander scale. For mentally ill people who are underserved, the emergency room is often their only option for treatment.
In an op-ed that appeared in the New York Times, psychiatrist Christine Montross wrote that it is not unusual for cumulative emergency-room visits to add up to more than twice the patient’s age, pointing out that a single hospital admission costs more than a year of private outpatient care would.
Impact of The ACA and The Final Parity Rule
Recent studies underscore the connection between mental and physical health, disputing the idea that mental illness is an isolated public health problem. Research at Harvard Medical School, for example, has shown a link between anxiety and several chronic physical illnesses, including heart disease, chronic respiratory disorders, and gastrointestinal conditions. And heart attack fatalities are linked as much to depression as they are to the top five risk factors: obesity, high cholesterol, diabetes, high blood pressure, and smoking, according to a study released in 2017.
Until the mental health parity law passed in 2008, insurance companies discriminated against mental disorders and limited access to treatment. The parity law requires health insurance companies to cover mental illness just as they do physical disease. Together with the Affordable Care Act (ACA) – which promotes access to mental health care by disallowing pre-existing conditions, limiting the amount consumers are required to spend on medications and increases access through Medicaid expansion – the parity rule was aimed at opening up mental health insurance coverage for millions of underserved people.
And yet, while progress has been made in the past decade, other more subtle obstacles to mental health care persist.
First, the good news. The parity law has reduced or eliminated certain barriers to treatment, among them charging higher co-pays or deductibles for mental health care. And yet, while insurance companies may comply with the parity requirements, they are finding other ways to limit access, Grohol said, such as limiting the number of in-network mental health providers. “They make different barriers, saying that a two-hour ride to get to the nearest therapist is accessible.”
According to Parity Track, which was started by former U.S. Congressman and mental health advocate, Patrick Kennedy, patients continue to face potential parity law violations. The organization educates consumers about their rights under parity laws, identifying common violations to mental health treatment, including:
While Parity Track aims to educate consumers about their rights, there are other forces at work taking a legal stance against insurance company violations regarding mental health parity. Psych-Appeal, a private law firm specializing in insurance coverage for mental health issues, pursues legal action against insurance companies. It was involved in a class-action lawsuit against United Behavioral Health – a unit of UnitedHealth Group. In March 2019, a federal judge in Northern California ruled in favor of the plaintiffs, stating that the insurer’s discriminatory policies aimed against patients with mental health issues was a violation of federal law.
- Separate deductibles for behavioral health services that are not part of the overall deductible;
- Higher co-pays for behaviors health services;
- Limits on how many times you can see a behavioral health provider;
- Charging more for prescription medications for behavioral health treatmet;
- Requiring permission for patients to continue behavioral health treatment;
- Limits on how many days are covered within a treatment facility.