Insurance Should Cover Mentally Ill

Posted March 9, 2008 at 10:59pm

It will be a landmark day when we realize that health is not just about fixing broken bones. It’s about having a healthy, complete individual from head to toe. Millions of Americans suffer from mental illness of some form — conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Mental illnesses strain families and can contribute to lost productivity, unemployment, substance abuse, homelessness or suicide. Few Americans are untouched by it. No one is immune.

Prompt and comprehensive treatment can enormously reduce

these effects, but insurance companies — including government plans like Medicare, Medicaid and the State Children’s Health Insurance Program — frequently impose limits on coverage for mental health that are not imposed on traditional medical and surgical care. Already this year, Congress has worked to address these inequalities in the federal health programs.

Last week, the House of Representatives took a significant step toward finally ending the insurance discrimination that has existed for decades against people with mental illness.

Reps. Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.) deserve credit for their strong leadership on the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424), which I am proud to co-sponsor along with more than 270 of my colleagues. This much-needed legislation would require insurance companies to provide benefits for mental health and substance abuse treatment equal to those provided for physical medical treatment.

The Paul Wellstone Mental Health and Addiction Equity Act would require that all Diagnostic and Statistical Manual of Mental Disorders illnesses be covered, rather than letting insurance companies determine their own scope of coverage. This is the same coverage requirements that we as Members of Congress receive under our federal employee health plan and our constituents deserve no less coverage.

The American Psychological Association, which publishes DSM-IV, reports that lack of insurance coverage (87 percent) and cost (81 percent) are the leading factors for individuals not seeking mental health services. The Paul Wellstone Mental Health and Addiction Equity Act would solve both of these problems.

Additionally, unlike the bill working through the Senate, H.R. 1424 would not preempt state law. This is very important for the residents of my home state of New Jersey and others who already have mental health parity laws on the books. For good reason, these states worry that they might be forced to reduce their coverage requirements.

We know that mental illness is treatable, yet because one-third of the people affected do not receive needed treatments, mental illness remains a leading cause of disability and premature death. According to the World Health Organization, the costs related to untreated mental illness are $147 billion each year in the United States. Those who oppose the legislation thinking it is too expensive should note this cost.

Yet, an analysis of the Paul Wellstone Mental Health and Addiction Equity Act indicates it would result in an increase in premiums of less than 1 percent and would reduce out-of-pocket costs by 18 percent. Further, a recent article in the Journal of American Medical Association indicates that employers who actively encourage their employees to use mental health services actually experienced an increase in hours worked and productivity gains.

Ultimately, despite the economic arguments in favor of parity, it is not a debate about dollars and cents, but about lives saved and people restored. I recently received a letter from a constituent who is a corporate human resources director. She did not write me in that capacity, however. Instead, she wrote me “as the sister of a beloved brother who committed suicide one day after his in-patient mental health care benefit ‘ran-out.’” She understood and related to me not only the human resources concerns, but also and especially, the true cost of mental health and the failure to enact mental health parity. Let’s work to ensure that those who need access to mental health care get it.

Rep. Rush Holt (D-N.J.) is a member of the Education and Labor Subcommittee on Health, Employment, Labor and Pensions.