Monday, March 9, 2015

Obamacare requires mental-health coverage to be at parity with other coverage, but 1/4 of plans don't do that, study concludes

Federal health reform "has improved access to mental health care for thousands of Kentuckians, but coverage for that care remains unequal to what people get for physical illnesses despite a federal law requiring parity and a promise that health reform would level the playing field," report Laura Ungar and Jayne O'Donnell of USA Today.

"If you need to see a cardiologist, the insurance company doesn't say you're not allowed to see the cardiologist more than a certain number of times. With behavioral health, you commonly see a limit on the visits you get," Tony Zipple, CEO of Seven Counties Services, the Louisville region's largest mental-health care provider, told Ungar, who also works for The Courier-Journal. "Behavioral health nationally is treated like a smaller part of health care."

Ungar and O'Donnell cite a study by the Johns Hopkins Bloomberg School of Public Health that found consumer information on one-fourth of plans offered under the Patient Protection and Affordable Care Act appeared to violate a federal law "designed to stop discrimination in coverage for people with mental-health or addiction problems," they write. "This makes it nearly impossible for consumers to find the best plan to cover their mental health needs, the research suggests."

Researchers found that different co-pays or deductibles for mental and physical health services, and more stringent requirements for authorizations from insurers before patients can get mental health services, may discourage people from buying such plans, said Colleen Barry, lead author of the study report, published in the journal Psychiatric Services. "She's concerned insurers have an incentive to do that because covering people who use mental health services tends to be more expensive," the story reports.

Clare Krusing, a spokeswoman for the lobby America's Health Insurance Plans, "said the rules contained some important changes affecting plan design that were only required for insurance plan years that started on or after July 1, 2014," the story reports. "Krusing added that it's unfair to say a plan doesn't offer mental health parity based only on what consumers see before buying the plans," and not the history of claims made under the plans.

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