"Pass the Wellstone Act"
By REGISTER EDITORIAL BOARD
No one gets to pick the illness that strikes them. Yet health insurers frequently get to pick which illnesses they'll pay to treat.
The 27-year-old woman with an eating disorder who walked into the office of Des Moines psychologist Sam Graham in 1993 didn't pick anorexia. It chose her the way mental illness has chosen about 44 million Americans. Yet her insurance company chose to pay for only 20 visits to a mental-health professional each year.
"I ended up treating her intensively within the limits of the year. She had problems with her kidneys and troubling feeding her kids adequately," Graham said. "She was referred by her family physician because her health was suffering."
He estimated she needed at least 35 visits and probably closer to 50 that first year. If she'd gotten them, "she would have gotten better sooner and her illness would have had a less negative effect upon her family," said Graham.
Yet when it comes to mental health, insurance companies fall short by limiting treatment. Though lawmakers in 38 states have passed mental health parity laws, Iowa lawmakers failed to do so again this year. Progress isn't any better in Washington where lawmakers have been long on lip service and short on action.
Now legislation in both the House and Senate would close loopholes that allow insurers to avoid the spirit of an existing law that requires equal treatment for mental-health coverage. The Paul Wellstone Mental Health Equitable Treatment Act has 68 cosponsors in the Senate and 243 cosponsors in the House.
Among Iowa's cosponsors are Senators Chuck Grassley and Tom Harkin as well as Congressmen Leonard Boswell and Jim Leach. Congressmen Steve King, Tom Latham and Jim Nussle have not signed on.
Nussle said he's "concerned about the effects of mandating additional insurance coverage on health insurance rates and the access to health care issues that result when individuals and small business can't afford to purchase insurance."
King's spokesperson Melissa McKay said the congressman opposes the parity legislation because "he has serious concerns that this measure would drive up all health care costs, let alone his opposition to government mandates on private industry."
The United States can't afford not to implement parity. Untreated mental illness costs businesses $70 billion a year in lost productivity and increased sick leave, according to the U.S. Surgeon General's Report on Mental Health.
Parity would increase the cost to employers by only $1.32 per enrollee per month, according to PricewaterhouseCoopers.
Plus, ensuring parity is right. Mental illness is a real disease the same way diabetes, cancer and heart disease are.
A fix on this issue should come from Washington. Though state laws can help, many insurers are not required to change a thing when state laws change. "Self insured" plans are exempt from state regulation, and it's estimated 25 percent of Americans are insured by these plans.
A federal mandate would directly benefit more Americans by requiring insurers to cover mental health the same way they cover other illnesses. It would acknowledge mental illness is a real disease.
N o one gets to pick the illness that strikes them. Yet health insurers frequently get to pick which illnesses they'll pay to treat.
The 27-year-old woman with an eating disorder who walked into the office of Des Moines psychologist Sam Graham in 1993 didn't pick anorexia. It chose her the way mental illness has chosen about 44 million Americans. Yet her insurance company chose to pay for only 20 visits to a mental-health professional each year.
"I ended up treating her intensively within the limits of the year. She had problems with her kidneys and trouble feeding her kids adequately," Graham said. "She was referred by her family physician because her health was suffering."
He estimated she needed at least 35 visits and probably closer to 50 that first year. If she'd gotten them, "she would have gotten better sooner and her illness would have had a less negative effect upon her family," said Graham.
Yet when it comes to mental health, insurance companies fall short by limiting treatment. Though lawmakers in 38 states have passed mental health parity laws, Iowa lawmakers failed to do so again this year. Progress isn't any better in Washington, where lawmakers have been long on lip service and short on action.
Now legislation in both the U.S. House and Senate would close loopholes that allow insurers to avoid the spirit of an existing law that requires equal treatment for mental-health coverage. The Paul Wellstone Mental Health Equitable Treatment Act has 68 cosponsors in the Senate and 243 cosponsors in the House.
Among the Iowa cosponsors are Senators Chuck Grassley and Tom Harkin as well as Congressmen Leonard Boswell and Jim Leach. Congressmen Steve King, Tom Latham and Jim Nussle have not signed on.
Nussle said he's "concerned about the effects of mandating additional insurance coverage on health insurance rates and the access to health care issues that result when individuals and small business can't afford to purchase insurance."
King's spokesperson Melissa McKay said the congressman opposes the parity legislation because "he has serious concerns that this measure would drive up all health care costs, let alone his opposition to government mandates on private industry."
The United States can't afford not to implement parity. Untreated mental illness costs businesses $70 billion a year in lost productivity and increased sick leave, according to the U.S. Surgeon General's Report on Mental Health.
Parity would increase the cost to employers by only $1.32 per enrollee per month, according to PricewaterhouseCoopers.
Plus, ensuring parity is right. Mental illness is a real disease the same way diabetes, cancer and heart disease are.
A fix on this issue should come from Washington. Though state laws can help, many insurers are not required to change a thing when state laws change. Employers that are self-insured are exempt from state regulation, and it's estimated 25 percent of Americans are insured by these plans.
A federal mandate would directly benefit more Americans by requiring insurers to cover mental health the same way they cover other illnesses. It would acknowledge mental illness is a real disease.
