Memo to All GA Members: Re: Mental Health Parity Act

By: Donkey Hotay
Published On: 8/14/2007 5:25:09 PM

MEMORANDUM

To: All Democratic Candidates for the General Assembly

Re: Mental Health Care Parity Act for the Commonwealth of Virginia

Background and Relevant Information:
Mental health care despite not being a particularly salient electoral issue is an issue that nonetheless is of great concern to many of your constituents.  In fact, approximately 1 in 4 Americans suffer from mental health problems at one point in their lifetime.  I'm sure that at various times in your career; whether on a School Board, dealing with the VT tragedy or various other occasions, you have seen first hand the damage that untreated/undiagnosed mental health problems can cause not only for the affected individual but for their family and fellow students/colleagues as well.  I'm writing to formally request and suggest that your campaign for election or re-election should pledge to support a Mental Health Care Parity Act in the General Assembly.

In short, Mental Health Parity requires that if mental health illnesses are covered by group health plans that they be treated the same as physical illness or surgery.  Health care providers would not be required to cover mental health but if they do provide that coverage they may not place restrictions on frequency of care, out of pocket expenses, co-payments, deductibles, etc...that are different from physical illness or surgery.  This is hardly a novel issue.  In fact, action is being taken at the federal level, as it has been for many years now, to have a national Mental Health Care Parity Act.  Legislation has been introduced in both the House and Senate which can be used as a model for Virginia legislation (see below). 

According to the US Senate Report accompanying the bill:

Additionally, it should be noted that a 2004 Department of Health and Human Services actuarial study of the impact of mental health and substance abuse parity on health plans under the Federal Employee Health Benefit Program (FEHBP) shows that utilization of services increased 15 percent from pre-parity levels, and yet the cost increase associated with parity was only 0.94 percent. S. 558 is, therefore, a fair solution to the injustices that people with mental illness experience while receiving treatment. It will save lives, increase the quality of life for group health plan participants suffering from mental illness, and save money.
Emphasis Added
The urgency is not simply a matter of ethical medical treatment in a health care system that is already broken for so many.  It is a matter of public safety and the very core value that government exists to protect its citizens from those that would do them harm, foreign or domestic as well as corporate or individual.  It is far too common to see patients admitted to a hospital with major depression (suicidal) and be released three days later without any medical improvement because three days is all their insurance would cover.  Yet, a patient admitted due to physical injury, even if caused by risky behavior while intoxicated or some other likewise avoidable injury is covered until cleared by a doctor.  Again, while physical out-patient rehabilitation is usually covered by insurance, mental health care out-patient costs are not guaranteed.  This difference in coverage is directly attributable for deaths (suicides and murders) of your constituents and additional cost to the Commonwealth in terms of incarceration and rehabilitation, increased crime rates, lower standard of life, lower educational performance and increased general welfare costs.

The only foreseeable Con in pursuing a Mental Health Care Parity Act would be push-back from the insurance industry lobby as well as a few extreme conservative voters.  Insurance companies oppose this type of legislation as it will increase their expenses due to the fact that they must increase coverage.  However, as noted in the DHS report the increased cost was less than 1%.  Extreme fiscal conservatives oppose this action as they view it as government intrusion into the free market.  However, this is a small percentage of voters and will be offset by support gained in the medical and social work industries in addition to the support of sufferers of mental health issues and their families (1 in 4 Americans)

Federal Action:
In the Senate: Paul Wellstone Mental Health Parity Act of 2007 (S.558) (57 bi-partisan co-sponsors), already out of committee 8-3
http://thomas.loc.go...

In House: Kennedy-Ramstad (268 bi-partisan sponsors) (in committee)
http://thomas.loc.go...

In past years Speaker Hastert has blocked Mental Health Care Parity Acts from coming to a vote on the House floor, despite coming out of committee with bi-partisan support.  Speaker Pelosi has promised a vote this year if it comes out of Committee.  Based on the fact that a majority of the Members have signed on as co-sponsors there is a high probability that it will pass this year.

Conclusion/Summary:
Congress appears poised to pass a Mental Health Care Parity Act this year.  I would recommend your campaign take up this an issue now so as to be seen as a pioneer in the field once Federal Legislation is passed.  There is also a possibility of a Presidential veto in which case the issue would be highlighted and framed as having come out of Congress with bi-partisan support and suffering an ideological veto by the President Bush.  You can position yourself to be a seen as a leader in Virginia of an issue with broad bi-partisan support but being stopped by conservatives for ideological reasons, similar to stem cell research, but with many less draw backs.

This is something that affects our community as a whole touching 1 in 4 of our families and does not discriminate on party, income, race or any other divisions.  We need to address this issue head on as the tragedy at Virginia Tech recently showed us.  Again, I urge you in the strongest possible terms to take on the cause of Mental Health Parity not only because it is politically advantageous but it's also the right thing to do.


Comments



For Those Concerned With Impact on Small Business (Donkey Hotay - 8/14/2007 5:27:15 PM)
I point to this section in the US Senate Report
Individual plans and employers with 50 or fewer employees are exempt from the law.

Additionally, group health plans that can demonstrate that compliance with S. 558 increased their actual total costs of coverage under the plan may elect to be exempt from parity under this act for the following plan year if it is projected that the health plan will experience increased actual total costs of coverage under the plan that exceed 2 percent of the actual total plan costs during the first plan year or exceed 1 percent of the actual total plan costs each subsequent year. It should be noted that group health plans could not permanently opt out of complying with the parity requirement and that the exemption under this section only applies for one plan year. It should also be noted that an employer may still elect to continue to apply mental health parity even if it meets the threshold for cost exemption.



Lack of Poll Usage (Donkey Hotay - 8/15/2007 5:34:34 PM)
Quick question to the Raising Kaine Community.

Why don't people answer the polls in diaries?  For example, this diary has three recs but only two votes (and one of them mine) and I can only assume that other people that did not rec the diary read it.

So what's up with the lack of clicking the yes/no/undecided button sharing your opinion (albeit briefly).



I don't know, I've wondered that for a while (Lowell - 8/15/2007 6:12:19 PM)
I've also wondered why people don't use the community features more, like diary recommend and rating other peoples' comments.  Any thoughts out there?


Is there a "Trusted User" system (Donkey Hotay - 8/15/2007 6:26:22 PM)
similar to DKos on RK? Or do troll ratings hide comments?

I guess I'm asking is there a tangible benefit?



Yes, the system is very similar to Daily Kos. (Lowell - 8/15/2007 6:57:50 PM)
Certainly, recommending diaries rewards people for writing good diaries.  And comments can be "troll rated" or rewarded.  Enough troll ratings and the comment disappears except for trusted users.  Very similar to Daily Kos, as I said.


Questions on the proposal (tx2vadem - 8/16/2007 11:26:12 PM)
What is to prevent insurance companies from dropping coverage?  On the cost side of the equation, why would insurance companies not just up their premiums?  And have those factors been considered in the legislation?