How does the bailout affect those with mental health issues?

[nandm]

I found an article that explains some of what the bailout did for us with mental health issues. It actually sounds like it will be beneficial. I always hated the fact that my mental health issues were not treated the same as my physical health issues, like they were not as important to my life.

Mental health parity gets OK'd through bailout
New protections require equal treatment of physical, mental ailments


updated 11:47 a.m. PT, Fri., Oct. 3, 2008
WASHINGTON - Talk about going out with a win.

Sen. Pete Domenici, R-N.M., has spent years fighting for legislation that would require insurance plans to treat mental health patients on par with those who have physical ailments. No more higher copays or deductibles for the mental health treatments. No more limits on visits to the doctor that differ from the caps for other patients.

Domenici, after six terms, is leaving office this year. One of his final votes was on the mental health legislation he fought so hard for over the years.
The mental health protections are part of a massive bill designed to help the economy that was passed by the House Friday and sent to President Bush for signing.

Domenici has a daughter diagnosed with atypical schizophrenia. He got involved in the parity issue after joining a National Alliance on Mental Illness support group nearly 20 years ago. On his way home from work, he and his wife, Nancy, would meet with other parents of children with mental health problems.

"The first real understanding of how broad the problem was came from those meetings where I met with mothers and fathers who had children who were mentally ill, and they were going bankrupt because they couldn't pay the health bills, or their children were in jails instead of hospitals," Domenici said.

He said perceptions about the ability to treat mental health problems have changed greatly over the years, but coverage has also become an expensive proposition. So, he and others, such as the late Sen. Paul Wellstone, D-Minn., began pushing for health insurance parity. Those who would have to bear most of the expense offered the most resistance.

"Those who stood to lose fought hard and that was principally insurance companies and businesses," Domenici said.

Employers and insurers were concerned that legislation would have required plans to cover a "telephone book" of conditions, raising costs beyond what companies and their workers could afford and potentially negating companies' ability to offer any health coverage at all.

If provided, coverage must be equal
The legislation does not mandate that group health plans cover mental health or addiction treatment, only that when plans do so, the coverage must be equitable to other medical coverage. The insurance industry is now a strong supporter of the parity legislation.

In 1996, Sens. Wellstone and Domenici won passage of a law banning insurance plans that offer mental health coverage from setting lower annual and lifetime spending limits for mental treatments than for physical ailments.

The pair again teamed up in 2001 on a predecessor to the legislation now before the House. After Wellstone was killed in a plane crash in 2002, Sens. Edward Kennedy, D-Mass., and Mike Enzi, R-Wyo., took on larger roles in getting a bill passed in the Senate.

The requirement for equal treatment in insurance coverage would apply to health plans that cover more than 50 employees — potentially reaching 113 million people nationwide.

Health officials contend that equal protections for mental health conditions would lead to a healthier, more productive work force.

"There's a phenomenon ... where you've got a psychiatric illness and you're able to get around but you can't do your work at the same quality you did before," said Dr. Nada Stotland, president of the American Psychiatric Association.

"Many workers today are in the service industry. If a person on the other end of the line is depressed, they may have shown up to work and they may be present, but they will not necessarily make us happy about the company that we're calling. They'll be slow, unhappy and maybe irritable, and their powers of concentration won't be good. So, more and more companies want to see their employees treated."

Overall, the parity legislation is expected to cost the federal government about $3.4 billion over 10 years. That's because employers will have more health expenses that they can deduct from their income taxes.

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

[Isaiah]

I know for me personally I've had probably about 10x as many "crazy days" taken off of work than I've had sick days over the last five years.

Good news for some if it comes about.

[daydream]

This is such good news! Does anyone know how soon this will take effect? I'm on regular Medicare. Because it only pays about 50%, I have skipped many appointments and have avoided telling my PD critical information because I knew it would run up my time and I would have to pay even more. A 15 minute visit costs me $35 and that's just long enough to answer her questions quickly and get new scripts. Trying to tell her anything else pushes me over to 20+ minutes and a $55 which I simply cannot afford at all. Hell, I don't even have the $35 to go on Tuesday, so looks like that one will have to be canceled too.

[shutterbug]

DayDream....man am i sorry to hear about the situation with the pdoc! That sucks! Is that the only way you can see a pdoc? I ask b/c in my state, when i lost my job and was on unemployment...i qualified for a state-wide program (that may also be national) where it didn't cost anything to see the pdoc and only $5 for every prescription (that was before the $4 meds thru Wal-mart and others).

If you want to PM me then i will tell you the name of the program, but since it may just be a state thing...i don't want to name it here. I also must say that the pdoc available wasn't very good, but being able to go to one at all is definetly better than not being able to go to anyone!

Nandm, thanks for posting this! It's very interesting to know about and also to know a bit about some of the legislators who are truely out there working to help those of us with mental illnesses!

It's definetly a step in the right direction! It'll just be interesting to see how it works in action....and hopefully it won't mean that benefits for other illnesses will be lowered so that employers and insurance peeps won't have to raise the MH benefits very much!

Jenna

[daydream]

Hi Shutterbug,
I am just barely over the income limit to be able to receive state-funded Medicaid where I could get mental health tx for virtually free. It's a tough spot to be in just barely over the limit, hardly getting buy, when people who get just a little less money qualify for hundreds of dollars in all sorts of benefits. Still, there is a large state-funded community mental health center where I could go for just $5 a pop. Problem is, I was a therapist there and got fired the day I returned from medical leave for tx of my bulimia and anorexia. Yes, I had taken a 3-month leave under the Family Medical Leave Act. They fired me the very day I came back and they got away with it. In any case, those people know me. there is no way in hell I'm going to reveal all my crazy where those ***holes can read it, nor am I about to walk into that building on a regular basis and have to see the people who treated me like crap. So I'm stuck having to go to a place that does not have state funding for low-income people.

[justanothrdrunk]

My understanding of mental health parity is that it only effects employer sponsored group health plans.

If I'm correct, this will not impact anyone who has an individual plan, Mediaid, Medicare, etc.

[justanothrdrunk]

Okay, just did some reading up on this... Source: Search Results - THOMAS (Library of Congress)

I was correct in that the new law only applies to employer sponsored group health plans. This will not impact Medicare or any publicly funded coverage. It also doesn't impact anyone who has their own individual plan they purchase directly from an insurance company. Since the new law amends ERISA, I don't think it impacts any ERISA exempt plans either. ERISA exempt plans would be smaller employer plans that are fully funded (as opposed to self-funded). Other ERISA exempt plans include certain religious organizations and any tribal organization protected by a sovereinghty treaty.

The one interesting piece I noticed is a cost exemption. If, after the first full plan year of this change in coverage, a plan can demonstrate a cost increase of 2% or greater, they can apply for an exemption. Once the exemption is granted, plans may reapply for subsequent exemptions.

In other words, if this new law costs plans too much, they can go back to their old coverage.

Also, this new law doesn't require any plan to offer mental health coverage. Those plans that offer limited coverage right now may elect to exclude all mental health treatment entirely under the new law.

[nandm]

Sounds like it is just another red herring the government has thrown us trying to keep us hopefully for change. Thanks for the info. I did understand it only affected the insurances that were already offering mental health services but did not understand that it was only private.

[justanothrdrunk]

Just got some more news at work about this thing.

Bill was signed into law on 10/3/08. It will go into effect on 10/3/09. That means plans that renew on or after 10/3/09 will have to bump up their mental health coverage to match any other illness, or drop their mental health coverage altogether.

Since the majority of employer sponsored ERISA plans renew on January 1, look for benefits to change as of 1/1/10.