Sunday, September 28, 2008

Continuing Progress on Mental Health Bulls

Editorial: Time for parity for mental health coverage

by The Grand Rapids Press Editorial Board
Sunday September 28, 2008, 3:00 AM


Mental illness can be just as terrible and even deadly as physical illness, but isn't treated that way by some insurers.

Diseases of the mind aren't always as visible or obvious as those of the body. But depression, schizophrenia and other serious ailments can be just as debilitating and deadly as diabetes and heart disease. Still, mental illness is too frequently treated differently by health insurance companies.

Last week, the U.S. House of Representatives passed a bill that will improve insurance coverage for people with mental illness. The bill caps more than a decade of debate on the question, and marks an important step forward in addressing diseases that are increasingly treatable and beatable, provided they receive proper attention and care.

The legislation mandates mental health parity, making it illegal for insurance companies to set lower limits on treatments than are set for physical ailments. The bill prohibits higher co-pays for mental health treatment, too. And it requires equal treatment for substance abuse, provided that it is offered by a medical plan.

Those provisions would end restrictions in many insurance plans that can force people with long-term illnesses such as bipolar disorder or anorexia to pay for their own treatment or forgo treatment altogether because they can't afford the cost.

A mental health parity bill has already passed the Senate by a vote of 93 to 2. The House legislation passed by a vote of 376 to 47.

The two versions need to be reconciled. President Bush has expressed support.

Nearly every member of Michigan's congressional delegation -- Democrat and Republican -- voted for the measure. The sole exception was Rep. Peter Hoekstra, R-Holland.

The bill could raise costs. Any hike in insurance premiums is difficult, especially given the skyrocketing price of health care generally. However, the Congressional Budget Office projected that an earlier version of the parity bill would increase premiums for group insurance rates by only four tenths of one percent.

Untreated and under-treated mental illness carries costs of its own, from worker absenteeism to family break-up. Building a better system of healing and prevention for mental illness will decrease those expenses to individuals and society.

The bill contains safeguards for small business, exempting those with fewer than 50 employees. The legislation does not mandate that mental health coverage be made available by businesses that don't currently offer health coverage. And it does not specify which mental illnesses should be covered, allowing health plans discretion to deal with more controversial and questionable diagnoses. If coverage is rejected, the bill requires a health plan to explain why.

In all, the measure strikes the right balance between costs and the health care needs of ordinary people. Those who suffer from mental illness -- estimates are as many as one in four adults in the United States -- know those conditions can leave them alone and adrift. Congress and the president can throw them a lifeline by completing and signing this important legislation.

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