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