The battle to obtain behavioral health services has long since been raging in the United States. Historically, the stigma surrounding mental illness and addiction has barred many from accessing treatment and has been reinforced by insurance carriers offering less coverage for behavioral health than somatic health. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) works to correct this grave history by providing many insured individuals easier and more affordable access to behavioral health care. Although individuals covered by this law should experience fewer barriers in accessing behavioral health care, several obstacles still remain.
A large factor regarding incompliance with the Federal Parity Law lies in implementation gaps. Advocates from MHAMD, NCADD-MD, and the University of Maryland Drug Policy Clinic have been hard at work shepherding a bill to address these consumer issues. The bills have now been filed in the 2015 General Assembly Legislative Session. Senate Bill (SB) 586, and its cross-file House Bill (HB) 1010, an act entitled “Health Insurance – Federal and State Mental Health and Addiction Parity Laws– Report on Compliance,” would allow the MIA to enforce full parity. As of now, parity enforcement is mainly a consumer complaint-driven process, requiring consumers to identify violations and file complaints. This process does not work as consumers do not have the necessary information to determine if their plan is in violation of parity. The new bill puts the consumers at the advantage by making the reports public and leaves ensuring parity compliance up to the insurance regulators.
The MIA attached a fiscal note to the bill as it interprets the language of the bill to mean additional staffing requirements and additional storage space. Not only have they been meeting with legislators all session to promote favorable support, they have also urged in bill hearings on February 25 and 26 that only the most popular plans from each carrier would need to have reports filed with MIA, reducing the projected amount of paperwork. There are numerous other supporters of these bills, including NAMI-MD, Psychologists Association of MD, Maryland Hospital Association, Health & Education Advocacy Unit at the MD Attorney General, various behavioral healthcare providers, and consumers who have had adverse experiences trying to get the behavioral health care they needed covered by their insurance. The opponents of this bill are the MIA and various insurance carriers. On March 4, Senator Middleton—Chair of the Senate Finance Committee—convened a work-group made up of advocates, representatives from community behavioral health centers, psychologists, psychiatrists, consumers who provided testimony at the bill hearings, the MIA and insurance carriers legal representative to see if the opponents and principal could compromise positions and move towards an agreement.
Although, the MIA and carriers may put up staunch arguments against burdensome paperwork, cost of additional staffing, and claim they are already compliant with Federal law the reality for consumers denied access to treatment due to high cost or long wait times far outweighs their complaints. This improves accountability and transparency among insurance carriers and makes choosing the right plan easier for the consumer. The new legislation emphasizes the fair treatment of individuals living with behavioral health issues and places value on their quality of life by expanding access to treatment through transparency in health plans.
If the bill successfully makes it to Governor Hogan’s desk and is signed into law, the full implementation of the report on compliance shall take place on October 1, 2015, just in time for open enrollment to ensure all consumers can choose a plan with the benefits suited towards their behavioral health needs.
To show your support for the Parity Report on Compliance bills, locate your legislator here and email your support of SB 586/HB 1010.