Help those with mental health issues by passing parity bill
Star Tribune - 3/17/2019
March 16--Jeff Christensen said his son took his own life in 2016 after his family fought unsuccessfully with insurers to get the 25-year-old into a specialized mental health program. Another Minnesota parent, Kelly Jay, told Minnesota lawmakers in a sometimes shaky voice how a health plan cut off coverage for her teenage son’s residential treatment program just days after his care providers took him off 15-minute, round-the-clock suicide checks.
In a somber session at the State Capitol on Tuesday, two families shared their pain with a House committee weighing a long overdue bill that would ensure that mental illness is covered by insurers the same as cancer, heart disease, diabetes and other conditions. The bill, which merits swift passage in the House and Senate, has a small but commendable cadre of DFL and Republican supporters. Their commitment reflects an admirable understanding of how common mental health diagnoses are, with 4 percent of U.S. adults struggling with a serious mental illness.
Regrettably, Rep. Greg Davids, R-Preston, callously made it clear on Tuesday that his sympathies lie not with the families, but with the insurers. Dramatically waving a sheaf of paper, Davids lamented the regulatory burden the bill would put on industry. He called it a “sledgehammer,” and said (with curious confidence, given that his party is not the House majority) that it’s going nowhere.
The tone-deaf theatrics were a low point of the 2019 session. No, Rep. Davids, the bill does not victimize insurers. In fact, not even the state’s insurance trade group is arguing that it would create unreasonable red tape. Nor does Davids have inside knowledge on how the Senate, which his party controls, will handle the bill. His bizarre bravado suggested the legislation would be dead on arrival in the upper chamber. A statement from the Senate GOP communications office on Friday said leaders have just started reviewing the bill. A spokeswoman added: “Rep. Davids does not speak for us.”
The bill will indeed be a tougher sell in the Senate, which is often viewed as friendlier to insurers than the House is. Still, there are influential Republican champions in the Senate, and their colleagues should realize it wouldn’t create a huge new set of regulations. The reality is that the bill would improve enforcement of a national law already on the books. That law, passed in 2008, mandates mental health “parity,” meaning equal coverage for mental and physical health conditions. But compliance has shamefully lagged. The evidence isn’t just in anecdotal stories like those shared Tuesday. Earlier this month, a federal judge slammed United Behavioral Health for discriminating against patients with mental illnesses in order to boost its bottom line.
The Minnesota bill would more rapidly shift enforcement from a system that is complaint-driven to one in which regulators proactively determine that insurers are in compliance, helping to avoid situations where treatment access is cut off or denied. As part of that, state officials would have clear authority from the Legislature to require data from health plans to assure parity is implemented. That would enable the deeper analysis required to ensure equitable care. Examples where the data may be helpful: reviewing whether patients have access to new drug treatments or whether their care options are disproportionately out of network. The bill would also require a yearly public report on compliance and enforcement actions.
Insurers should already be analyzing internal data to ensure that they’re in compliance with the 2008 law, so asking them to provide that information to the state when asked isn’t onerous. The amended bill also would streamline the reporting requirements, so it’s doubtful that the thick pile of paper waved by Davids is accurate. In an interview, Davids disputed an editorial writer’s characterization of his behavior and said he remains a health care advocate.
The Minnesota Council of Health Plans does have concerns about the bill. The main one, the trade group said in statement this week, is that it’s not a panacea for parity. Many employers’ plans are regulated at the federal level, so the safeguards put in place by the state may not yield improvements for these health care consumers. The council, and Davids, prefer a work group approach to improve parity.
The Star Tribune Editorial Board disagrees. Struggling families, not the industry’s preference for legal compliance, should be the priority. The trade group is right that the bill would help some but not all health plan enrollees. Nevertheless, it is a step forward and would send a strong signal that compliance is critical. Said Kelly Jay, who testified this week with Jeff Christensen: “Jeff lost his son. And I’m working very hard to get my son the treatment he needs. We don’t have time for work groups. We need this enforced.”
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