COLUMBIA — Advocates and health professionals in Missouri are hailing a mental health parity bill signed into law Oct. 3 as part of the federal government's economic bailout legislation. The mental health bill requires that health insurance firms extend coverage to treatment of mental health and substance abuse.
"Advocates and families of mental health patients had been pressing for this for many, many years," said Bob Bax, director of public affairs at the Missouri Department of Mental Health. "It is only fair that mental illnesses is covered the same way as physical illnesses are covered."
With the federal law, mental health conditions such as depression, bipolar disorder, schizophrenia and substance abuse will get the same coverage as other physical illnesses, such as heart diseases and high blood pressure. The law will go into effect on Jan. 1, 2010.
Missouri's latest mental health parity bill was passed in 2004, but it does not require insurance plans to cover substance abuse, Bax said.
"It is also an issue of integrating both physical and mental illnesses. For so long, the medical sector has separated the mental and physical illnesses," Bax said.
The bill has been the main legislative focus for National Alliance on Mental Illness for years.
"Since most insurance is purchased by employers, this has meant that the employer is making decisions about whether their employees and their families receive mental health treatment or not," said Tim Harlan, a former state representative who belongs to National Alliance on Mental Illness — Columbia.
"Sixty percent of the insured in Missouri get their insurance not from insurance companies but from self-insured employers," Harlan said. "Insurance policies are regulated by the state, self-insured plans by the federal government. That's why this bill was so important. The bill means that all Americans with insurance will finally have parity between mental health and other illnesses."
Missouri has 400,000 people who need help with substance abuse, Bax said. Figures estimate 300,000 people in Missouri with mental health needs.
But Molly White, managed care and insurance regulatory manager with Missouri Department of Insurance, Financial Institutions & Professional Registration, said she's worried that the federal legislation "may be written in a manner that allows an employer to drop coverage altogether rather than give equal mental health benefits to employees."
White said the strength of Missouri's mental health parity laws will keep the federal bill from bringing dramatic change in the workplace.
"The federal law does not pre-empt stronger state laws," she said.
She said the legislation will help working parents with children who have mental health needs more than it will help employees.
Bax, citing figures from the Congressional Budget Office, said the legislation would mean an estimated 2 percent increase in premiums under insurance plans drawn up by employers.
"But it would be worth the treatment provided to individuals," he said. "The employers will have a healthy workplace to begin with."
The bill has not been well-received by all sectors. For some small businesses that have been struggling to provide health care coverage to employees for years, it means more trouble.
"They have seen 20 (percent) to 30 percent increase in premiums just about every year," said Brad Jones, state director of National Federation of Independent Business. "There has been a decline in coverage over the last several years because of the increase."
The small increase in premiums by 1 percent to 2 percent will also add up, Jones said. "The rise in insurance costs led a lot of smaller businesses to be very creative in purchasing choice."
Employee-sponsored health coverage for full families is also getting rare, he said. Other options for small businesses will be laying off people, particularly part-time employees, to cope with the costs, Jones said.
It is a misconception that smaller businesses are able to pass the costs on to their employees, he said. "They have to keep their costs down and will be looking at what coverage they can afford."