Kennedy mental health law still encountering barriers

It was fall 2008 and the economy was plummeting. The financial crisis was the only issue on anyone’s mind.

So, as Patrick Kennedy tells it, he called his ailing father to ask for a favor.

Kennedy, then a Democratic congressman from Rhode Island, was the lead sponsor of legislation aimed at getting insurance companies to cover behavioral health services in the same way they did physical health. But, with Congress focused on saving the economy, Kennedy saw chances for his bill’s passage slipping away.

The late Sen. Ted Kennedy, D-Mass., had co-sponsored a similar measure in the Senate. The young congressman asked his father to use his goodwill to press colleagues to take up their mental health bill. The elder Kennedy called his friend, Sen. Chris Dodd, D-Conn., who at that moment was the most powerful man in Washington, as the chairman of the Senate Banking Committee, to see what could be done.

And something could: Dodd used Rep. Kennedy’s mental-health bill as the vehicle for the bank bailout known as the Troubled Asset Relief Program, or TARP.

“I’m the sponsor of the largest federal bailout in American history,” Kennedy said in a recent interview. “The good news was [mental health parity] passed. The bad news was that no one knew about it because it was overshadowed by the economic aspect of the bill.”

The law requires an insurance company to offer mental health and addiction treatment coverage on par with its physical health benefits. The requirement was then bolstered a few years later by the Affordable Care Act, which made behavioral health an essential benefit in plans offered on the individual and small-group marketplaces.

Yet in the decade since that law’s passage, there still remain barriers to care for people with mental-health conditions or substance-abuse disorders. Congress took another big step yesterday when it passed a large package of bills aimed at the opioid epidemic -- but experts warn that it is far from enough to truly tackle the scope of the problem.

So, to mark the 10th anniversary of Kennedy’s bill passing, the former congressman, with a group of other mental-health advocates, released an analysis that found 32 states did not ensure equal coverage for behavioral health.

The report, a joint effort by the Kennedy-Satcher Center for Mental Health Equity, The Kennedy Forum, The Carter Center, and Well Being Trust, gave each state a letter grade on questions like whether an insurer requires a patient to pay a separate deductible or higher co-pays for behavioral health or sets limits on how many times they can see a behavioral health provider.

The worst offenders, according to the report, were Wyoming, Arizona, Idaho and Indiana, which all received Fs. The only state to receive an A was Illinois.

“When you’re in the midst of a mental health crisis you don’t have the time to fight with your insurance company,” said Dr. Glenda Wren, director of the Satcher Health Leadership Institute Division of Behavioral Health. “We put so much on the shoulders of people in the worst possible places in their life.”