Striving for Equal Coverage for Mental Health

This summer, the U.S. Senate is expected to vote on a bill that could help enhance access to mental health treatment for more than 113 million Americans by requiring that private health insurance provide equal coverage for mental health treatment. In New England almost 6 million people could benefit.

More than 44 million Americans have some kind of mental health disorder. One-third receive treatment, and many more are undertreated. Insurance companies continue to discriminate against those with mental health disorders. Arbitrary limits on the number of treatment sessions, higher copayments, and higher deductibles are not uncommon for those seeking treatment.

And yet, according to the President’s New Freedom Commission on Mental Health, early detection, assessment, and access to treatment can effectively help those with mental health problems.

This issue is felt acutely in New England. Last month, federal government data ranked New England states among those with the highest incidence of depression in the United States. The National Survey on Drug Use and Health by the Department of Health and Human Services looked at the percentage of adults experiencing a major depressive episode in the previous year. Connecticut, Maine, and Rhode Island all ranked in the top 20 states with the highest depression rates.

Untreated depression has serious consequences, not only for individuals and their families, but also for the economy. Depression results in more days of disability than chronic health conditions such as heart disease, hypertension, and diabetes.

The Mental Health Parity Act of 2007, sponsored by U.S. Sen. Edward Kennedy, was approved, 18 to 3, by the Health, Education, Labor, and Pensions Committee in February. Some version of this legislation has been on Congress’ docket for 10 years in an effort to add to a limited law enacted in 1996. No bill has made it to the floor for a full vote of either chamber.

This year could be different. Parity is gaining strong bipartisan support. Previous opponents — the employer and insurance communities — have joined forces with mental health advocates to support the Senate bill, which will apply to all private employer health plans with more than 50 employees. Employers, though traditional opponents of parity, are beginning to recognize that the benefits of offering strong mental health treatment plans go beyond any minimal additional cost, lowering overall health care costs, reducing absenteeism, and increasing productivity.

The legislation is threatened by some who are concerned a new federal law would replace existing state laws, even if those state laws provide more protection. This concern is hardly surprising given the recent history of prior attempts to preempt state law in this area, such as Congress’s failed attempt last summer to put insurance regulation in the hands of the federal government. That concern is misplaced.

The Senate bill is written to preserve and enhance the good work that some states have done by enacting their own statewide parity laws that increase access to mental health treatment. It establishes a minimum federal foundation on which the state laws can rest. Those states that presently have limited or no parity would be improved, while state laws with more protections than the federal law will be preserved.

In Massachusetts, for example, where a 2000 state law on parity currently covers only certain diagnoses, the federal and state laws would combine to form better protections. Under the Senate bill, federal law would extend parity for treatment of a full range of mental health diagnoses. It would also provide parity for the first time to 1.5 million state residents in self-insured employee benefit plans that are currently exempt from state parity laws.

For the first time in a decade, we have a real opportunity to gain parity in insurance coverage for millions of Americans. Let’s not lose this chance.

Dr. Russ Newman is executive director for professional practice for the American Psychological Association. This article first appeared in the Boston Globe.