Maine Mental Health Parity Coalition - Supporting Access to Mental Health Care

Note date and time of public hearing and LD 364 number.

Title:  Maine Mental Health Parity to Protect Access to Mental Health Care

Public Hearing for Maine LD 364 Resolve, Directing Updated Review and Evaluation of Maine's Mental Health Parity Law is scheduled for Wednesday March 2, 2011 at 9:30 AM with the Joint Standing Committee on Insurance and Financial Services room 220, Cross Building in Augusta.

Consumers of Mental Health Care are supported by the language in this resolve.

Advocates for Maine’s mentally ill, including those who care for them and consumer groups quickly developed a broad based coalition in the fall of 2010, to support a coordinated and forceful pushback to prevent attempts to repeal health care reform initiatives involving Mental Health Parity for insurance beneficiaries. 

Former Maine State Representative from Auburn Susan (Dorr) Lamb, now Executive Director of the Maine Chapter of the National Association of Social Workers (NASW) in Augusta, joined the Maine Association of Psychiatric Physicians (MAPP) to assemble a group of interested parties to strategize against any potential legislative roll back of Maine’s first in the nation Mental Health parity law. 

What is Mental Health Parity?  Parity means “equal”.  In a nutshell, mental health parity protects care covered under the beneficiary’s health insurance plans, requiring they be paid for like any other medical health care claims.  In other words, parity means no extraordinary exclusions for mental health care coverage.

Maine’s mental health parity law became a national public policy leader when State Representative Dorr led efforts to pass the law when she was in the legislature. 

In effect, the Maine Mental Health Parity law mandates offering coverage for all individual and group plans for serious mental illness for company plans, but with a 20 employee or less exemption.  It provides coverage for broad-based mental health disorders and substance abuse disorders.

Mental Health as a Medical Health Benefit:

As health care costs increase, many public and private health plans have imposed stricter cost containment techniques on the health benefits beneficiaries pay for in their insurance plans. Many plans have subjected addiction and mental health benefits, often called “behavioral health” benefits, to an even stricter form of cost containment, often in the form of higher co-pays and deductibles, shorter day and visit limits, pre-approval or “prior-authorization” for these services and other forms of “medically managing” these benefits that are more stringent than how other medical benefits are managed. (Parity Toolkit for Addiction and Mental Health Consumers, Providers and Advocates.)

Background on Parity        

Most Americans with health insurance face greater barriers in accessing services for

mental illness and addiction than they face for accessing care for other medical

conditions. The majority of health plans impose higher out of pocket spending

requirements and more restrictive treatment limitations on addiction and mental health

benefits. Today, with new medical technologies like MRIs and PET scans that allow scientists to look inside the brain, the evidence that mental illness and addiction are brain diseases is more compelling than ever before. Unfortunately, reimbursement policy has not kept up with science.  Since 1992, advocates have fought for health care equality for those with addiction and/or mental illness. A federal partial mental health parity law was passed in 1996 that was a significant step forward. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 to correct discriminatory health care practices against those both with a mental illness and/or addiction. Significantly, the law aims to curb both the financial and non-financial or “non-quantitative” ways that plans limit access to addiction and mental health care. Individuals with mental illness and/or addiction, their families, professionals in the field and employers worked together to pass the law.

Does Mental Health Parity save health care dollars?  The Maine Mental Health Parity coalition is requesting in the Resolve for the Bureau of Insurance to provide an evaluation of the state’s law in light data showing how access to mental health care reduces acute care health expenses. 

Linked to this blog are two documents:  (a) Mental Health Parity Tool Kit http://www.nami.org/Template.cfm?Section=Parity1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=108469  or at http://tinyurl.com/5rhxco3

and (b) a copy of LD 364 the Resolve, Directing Updated Review and

Evaluation of Maine's Mental Health Parity Law. http://www.mainelegislature.org/legis/bills/bills_125th/billpdfs/HP029001.pdf

The Maine Mental Health Parity Coalition appreciates personal written testimony in support of the resolve to the Joint Standing Committee on Insurance and Financial Affairs Committee at the address:  http://www.maine.gov/legis/house/jt_com/ifs.htm

Insurance and Financial Services
c/o Legislative Information
100 State House Station
Augusta, ME 04333

Egyptian Zen

Egypt's brave people showed extraordinary resilience during their facebook revolution, rising up against 30 years of governmental tyranny. Therefore, I hope the Egyptians will kindly accept my Zen advice knowing it is offered with extreme admiration.

Zen Buddhism is not my specialty, but having watched the movie Charlie Wilson's War recently, the character played by the actor Philip Seymour Hoffman tells a story worth repeating here.  His character warns Congressman Wilson about the Zen of winning a war.  I'm adapting the story to Egypt and it goes something like this:

"A young Egyptian boy gets a pony for his birthday.  His village is so happy, they say 'isn't this good?'. But, the father says, 'We'll see'.  So, later, the boy badly damages his leg when he falls off the pony.  The village people say, 'this is not a good thing'. But the father says 'We'll see'.  Then, Egypt goes to war with Israel in 1972, but the boy cannot serve because of his injured leg, so the village says 'this is a good thing'. But the father says, "We'll see".  At the end of the story, the outcome of Charlie Wilson's War was not what he intended when he began his Congressional deal making.  His victory was short lived.

In other words, although the Egyptian people are justifiably exalted about their recent revolution to overturn a dictator, the unintended consequences and benefits are yet to be determined. To coin a sometimes overused cliche: "Freedom is Not Free". There may be a price yet to be paid for the people's victory.

Facebook gets credit for providing the matrix to fuel the people's demonstrations against President Hosni Mubarak; but it was the dictator himself and his autocratic rule that caused the Egyptian revolution. 

The Middle East is now a tinder box as a result of two back to back revolutions fueled by the power of social networking media - Tunesia and then Egypt.  Two revolutions will cause a physics-lab type of equal and opposite reaction on the part of other Middle Eastern dictators, of which there are apparantly several.

In the Zen philosophy, facts are not necessarily what they seem.
Egypt's euphoria may be short lived.  "We'll see".

*Note:  March 3, 2011 addendum -  http://www.bbc.co.uk/news/world-middle-east-12634117 
"Egypt's Prime Minister Ahmed Shafiq Resigns"

Juliana L’Heureux: Franco-American Studies sponsored by Rep. Brian Bolduc | The Portland Press Herald / Maine Sunday Telegram

Juliana L’Heureux: Franco-American Studies sponsored by Rep. Brian Bolduc | The Portland Press Herald / Maine Sunday Telegram

French settlers pre-dated the Plymouth Pilgrims by 17 years by settling St. Croix Island and Canada in 1604. Yet, French settlements in North America are taught like they don't matter much. More emphasis is given to the exploration of rivers than to settlements that pre-date the English colonies like Plymouth and Jamestown. It's time to include the St. Croix Island history in all school curriculum. In New Brunswick Canada, a Provincial legislator once told me St. Croix Island is like the Canadian Plymouth Rock. Rep. Bolduc may be starting a national curriculum trend, but let's lead by adopting this history in Maine, where it all began. Dirigo!