July 9, 2018
Other Voices

Mental health insurance coverage is at risk

Kate Mattias

Millions of Americans live with mental health and substance-use conditions.

Unfortunately, they have struggled to receive the same level of care for their mental illness and substance-use disorders as for their other healthcare conditions. Until the last decade, they often faced blatantly discriminatory practices when purchasing insurance.

Many Americans — including thousands in our state — still could not access mental health and substance-abuse coverage because of restrictions on pre-existing conditions and unreasonable limits on care.

The National Alliance on Mental Illness in Connecticut (NAMI Connecticut), part of the National Alliance on Mental Illness, successfully fought for passage of a federal parity law that helped improve coverage for mental health and addiction treatment. And locally our fight continues for improved implementation of Connecticut's parity law. Although Senate Bill 384, which sought to strengthen monitoring of Connecticut's parity legislation, was defeated at the last moment in the past legislative session, we continue to work with other advocates to make this a reality.

The Affordable Care Act (ACA) eliminated many of the inequities in health insurance by prohibiting discrimination against people with pre-existing conditions. The ACA also required plans in the individual market to cover mental health and substance-use services. Consequently, millions were able to get — and afford — the mental health care they needed.

The law currently protects people with pre-existing conditions. However, the federal government has advanced changes that roll back consumer protections. These changes would open the door to discriminatory health insurance plans and weaken protections for pre-existing conditions — like mental illness — that would jeopardize mental health care and undercut insurance plans that provide fair coverage.

A new report released by NAMI, "Mental Health Parity at Risk," looks at mental health and substance-use coverage before the ACA and shows just how dangerous it could be to remove these consumer protections, taking us back to a time when it was acceptable for insurers to treat mental health and substance-use conditions inequitably.

For example, before the ACA was passed, over half of states had no requirement that individual-market plans cover or even offer mental health services. And before the ACA, if a person with a mental health or substance-use condition could get insurance and afford it, they often faced limits on outpatient visits, yearly or lifetime caps on coverage and limits on coverage for mental health medications.

Now, the federal government has proposed a rule to expand the sale of short-term limited duration plans, a type of health insurance plan that does not have basic consumer protections. These plans would not be required to cover pre-existing conditions like mental illness or cover mental health and substance-use care. And earlier this month, the Department of Justice announced that it will not defend the ACA's consumer protections for pre-existing conditions.

The bottom line is that weakening insurance protections hurts people with mental illness. We call on legislators and the insurance commissioner to protect our citizens that live with mental health and substance-use conditions by maintaining consumer protections and not allow plans that fall short, such as short-term plans, to be sold in Connecticut.

Kate Mattias is the executive director of the National Alliance on Mental Illness in Connecticut, which provides support and education programs and has advocated for individuals with mental health conditions in the state for over 30 years.

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