Friday, October 24, 2008

Mental Health Coverage in US is Law!

It took a long time, well over a decade, but those of us who live in the US will now have mandatory mental health coverage.

The Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act of 2008, also known as Mental Health Parity, states that no insurance company can discriminate against mental health coverage or susbstance abuse treatment.

This means:

* No person can be "cut off" from mental health care with an arbitrary number of visits.

* No person can be forced to pay out-of-pocket for mental health care.

* Any person who has been "locked out" from mental health insurance will now have the opportunity to access such care.

The Mental Health Parity Act will be in full effect by January 1, 2010, but many states are already rolling this law into their books. So, as the new year approaches, find out if you live in a state that has its parity laws up and operating.

Now all we need is universal care for every person. No one should be without medical or mental healthcare.


Anonymous said...

Hurray! Good news indeed. It's about time this country has realized how valuable our mental health is.

Mz.Elle said...

Oooh this is wonderful news!!

Unknown said...

Hi Deb: So glad that the U.S.has finally done this, In Canada we have never had to pay for it or any other health coverage, so that is great news for the U.S....take care..Mary

The Lone Beader® said...

I would be happy with national health care!

OHN said...

So I would imagine that my next benefits package will not limit mental health visits to 12 per year. I have always thought that was ridiculous and never understood how they could consider once a month therapy to be adequate for someone in distress!

Yippee for the new law :)

Angel Chasse said...

That is great news, I hadn't heard this on my local news at all yet, thanks for bringing it to our attention! Makes me happy to see this in a time when the political ads are getting to be so many... seeing that something was needed, and got passed!!

Have a great weekend!


PTC said...

That's excellent!!

Kahless said...

This is fantastic.

And very important.

Tery Lynne said...

I love your blog - you truly educate us. I did hear this though awhile ago.

I am one of those that says, "I will believe it when I see it." :)

SaddleBumRN said...

Yahooo!! And about TIME! I knew they were talking about that bill, but didnt hear anything had gone thru yet. Thanks for the update.

Awake In Rochester said...

What if you don't have health insurance? How do I fine out if N.Y. has coverage?

Raine said...

Thats great news!

shrink on the couch said...

I felt extreme ambivalence (cognitive dissonance, hello?) when I learned that the mental health parity law was being tacked onto the bailout, er, rescue package. I very much believe in parity, for multiple and obvious reasons. I very much was in favor of the rescue package. However, I am dismayed by the tacking on legislative process in the midst of a national crisis. But it tis what it tis and now it clearly tis. And now I can shake it off and just celebrate. Its finally happenin. Thank you Pete and Paul (now you truly can rest in peace).

CrackerLilo said...

I am so glad this happened. Way too many people, including insurers, still act like mental health issues are your fault. Thanks for sharing this!

United We Lay said...

This is a wonderful thing. And I agree about universal health care.

Scott said...

Yeah, that is good news. Unfortunately, it WILL be plauged by chronic system abusers. But I think the good outweighs the bad. We need to do something major to give health insurance companies a reality check. They can't keep abusing people, which seems to be their business right now.

I can't wait until that carries over into the rest of healthcare! Sick people need to get better--NOT worry about getting dumped off their health insurance if they've "costed too much!"

Anonymous said...

wow, this is very, very good news. This will make such a huge difference in peoples lives!

Jennifer said...

Wow, I am so excited about this! I am only covered for 26 mental health visits per year, which I exceed half way through the year since I go to therapy every week. Even though my therapist allows me to pay based on a sliding scale, it is still really hard for me to make ends meet during the last half of the year. I have even had to limit therapy to once every other week sometimes to afford it, which really isn't good for me, if anything I should be going twice a week sometimes. I just wish this was going into effect in January, that means I have one more year of paying out of pocket for half the year.

By the way, it's "Paul Wellstone" with a "t" :-)

Dr. Deb said...

I agree

It is a loooooong time coming.

I have many Canadian friends who have said their own healthcare was wonderful. Sometimes I think I would like to move there!

Lone Beader,
That's the next thing!

No limits on visits is a great thing!

I was so happy to read the press release.

It will be life saving benefit for some!

We needed this in the US badly.

Well, you can believe now ;)

SaddleBumRN ,
It is a great achievement!

Awake In Rochester,
Check out the NYS insurance department website.

IT is a good good good thing. Now all we need is healthcare for every person.

phd in yogurtry,
We should have "Clean Bills". I totally agree with the slippery backdoor way things get done.

Oh yes. Hopefully this new law will educate others too!

United We Lay,
Yup. Me too.

Jedi Master Daryl,
I believe there are more good than evil people with things like that. System abusers will always exist as you say, but to call them out (patient or doctor) is what the rest of us need to do.

We are slowly getting wise like you Canadians!

I know what you mean! Got the missing T in there, thanks ;)

traci said...

I am so grateful that my place of employment began to follow this practice last October. I was stunned to discover a change in our insurance coverage that actually HELPED me! It's about time our country and the people in it realize that mental illness is not a character flaw.

mckait said...

This is good news. A good friend of mine who had a dx would have been so much better off if this had been in place years ago. He passed away recently.

I am also interested in learning more about PAS, as discussed in your previous post. It might explain some of what I see every day. I doubt I will ever truly understand, but I want to try.

Deb... I read a book I think you would like... HEART IN THE RIGHT PLACE is a memoir. A beautiful one. is my review. It was written by Carolyn Jourdan.

take care

Anonymous said...

It's about time! I hope the insurance companies don't raise their rates to cover this.


Anonymous said...

I hate to interrupt the party here, but there are a few downsides to this law:

1. Insurers aren't simply going to "absorb" or "write off" the costs associated with increased services. Insurance/HMO premiums are going to go up, and it's very possible that some people will be priced right out of the market and left with no coverage at all.

2. Since some clinicians and facilities will no doubt abuse this law to justify long-term and ineffective "cash cow" therapies and hospitalizations, the insurers will almost certainly INCREASE their level of regulation. Just because an insurer can't limit services or a number of sessions doesn't leave the powerless to pay for whatever the clinician decides. They still have the power to decide who will and will not be part of their panels and preferred provier groups...they'll simply choose only those clinicians who limit or restrict services on their own. (And many clinicians, deperate to make a living in an overcrowded market, will be more than happy to oblige in return for the assurance of a steady referral stream.)

There are lots of other unintended consequences I haven't gotten into here...but my point is, get your celebration in now before the real impact of this law hits society.

Cate Subrosa said...

Great news :)

Jade said...

Wow what a wonderful accomplishment. Its too bad it will not be enforced until 2010 but its a huge step in the right direction non the less.

ania said...

Much of this sounds wonderful.

I hope that its intent is realized in practice.

With warmth....

Id it is said...

"Now all we need is universal care for every person. No one should be without medical or mental healthcare."...I second that and I know there are thousands out there who'd second you as well!

Dr. Deb said...

Thanks for all your comments on this subject!

therapydoc said...

Right on, Dr. Deb.

Lisa Emrich said...

I agree that this is a good move in the right direction. However, as a self-employed person with individual (non-group) health coverage, it won't help me gain visits each year. Why does it have to be tied to group insurance?

Tom Smith said...

The new parity bill is clearly a huge step in the right direction, even though it is not the best bill and insurance companies have a history of manipulating circumstances to their benefit, not the insured. Using this bill as a framework, there still needs to be aggressive advocacy on the state level to make the bill functional and effective, and to improve some of its weaker provisions.

I became involved with these kinds of issues because our daughter had bipolar disorder and died by suicide in 2003. We (my wife, our son – Karla’s twin- and I) formed the Karla Smith Foundation ( to “provide hope for a balanced life to family and friends or anyone with a mental illness or who lost a loved one to suicide.” Our work with the Foundation puts us in constant touch with the families and friends of people with mental health problems, and we know the struggles many of them experience. They are very interested in the bill also.

Tom Smith
Author of "A Balanced Life" and Co-Founder of the Karla Smith Foundation

Anonymous said...

This is wonderful news. I think it helps to de-stigmatize mental illness too.

Anonymous said...

I hate to rain on the parade, but I think the problem is much bigger than creating a law mandating insurance coverage.

As another poster noted, insurance companies are not simply going to eat the cost. This means that premiums are going to go up, in many cases double digit increases. Who ultimately pays? many people simply cannot and will not be able to afford the much higher premiums. Look at the numbers of uninsured in the earlier economy. How on earth can higher premiums in a more challenging economic environment really succeed? Furthermore, the people most likely to have difficulty affording a plan that provides substantial coverage are the ones most likely to need it.

Moreover, what I have found in my area is that a majority of mental health providers listed in the preferred network practice in two locations. One for a day or so each week with a very small, closed panel- usually affiliated with a hospital or university. This provides them some privileges and status. They then have a second, private practice that does not take insurance- it's self pay/self bill.

The result? very few of the hundreds of providers have real openings. Also, I think that given the shortage of MH providers and the demand for services, many will turn to private practice, which I imagine is more lucrative than the PPO network.

Just because a service is covered doesn't mean a provider will be available.

Unknown said...

I'm in tears - relief!

Anonymous said...

God Bless people of America!