In Arizona most employer-based health plans do not offer the same level of coverage for mental health services that is provided for other illnesses, often forcing a person with a mental illness or a substance abuse disorder to either go without care or obtain services from the already over-burdened public health care system.
House Bill 2209 currently before the Arizona Legislature, seeks to remedy this inequity in coverage by mandating full parity for mental health services. HB 2209 prohibits group health insurance plans from imposing additional financial requirements, like higher co-pays and deductibles, as well as treatment restrictions; limitations on hospital stays and number of visits, cost and access barriers that do not occur with coverage of any other medical condition.
Higher co-pays and deductibles often reroute treatment through primary care physicians. When this occurs, medication is often the only treatment option, rather than the accepted best practice standard of counseling and medication combined.
Limitations on hospital stays and number of outpatient visits often result in an interruption of treatment prior to recovery. Imagine having to discontinue dialysis because you have used up your allowed visits or being forced to leave the hospital prematurely after heart surgery, even if complications occur.
Inadequate behavioral health coverage has financial impact for businesses. Employers experience high rates of absenteeism, tardiness, and an overall lowered work performance on the part of their employees. This loss of productivity, due to illness and mortality costs due to premature death, amounts to billions of dollars annually.
Arizona is one of only nine states where businesses cannot provide equal mental health coverage because insurance companies refuse to offer it.
At one time, there was broad belief that implementation of mental health parity would result in substantial increases in health care costs.
National actuarial studies and actual state experiences proved that from 1984 through 2003, implementing parity resulted in cost increases of less than 1 percent. The 2006 Federal Employees Health Benefits study found that when comprehensive mental health coverage is combined with managed care, the reduction in the utilization of general medical care and the associated costs result in a significant decrease in the cost of insurance premiums as well as employees’ out-of-pocket expenses.
Nationally, an estimated 22 percent of the population 18 and over suffers from a diagnosable mental disorder. Because the lack of mental health parity results in high percentages of untreated mental illness with accompanying human and economic costs, providing comprehensive mental health coverage at levels commensurate with the coverage available for all other illnesses is an important public health issue.
Currently, HB2209 is being held in the Senate Appropriations committee with no chance of passage. Since there is no impact on the state budget, Senate President Tim Bee, R-Tucson, can and should withdraw it so it can continue to move.
Susan Higgins is executive director of the Arizona Public Health Association.
Sherri Walton sits on the board of directors of the Mental Health Association of Arizona.