The Middletown Press (Middletown, CT)

NAMI report shows mental health insurance coverage is at risk

- By Kate Mattias Kate Mattias is executive director of the National Alliance on Mental Illness in Connecticu­t.

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 health care 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 preexistin­g conditions and unreasonab­le limits on care.

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 SB384, a bill that 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 preexistin­g 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 preexistin­g 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 preexistin­g 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 preexistin­g 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 preexistin­g 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.

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