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Mental Health Parity Bill Approved by the House Commiittee on Health Care Policy

February 4, 2004
By: Gaurav Ghose
State Capital Bureau

JEFFERSON CITY - Edward Duff says his mental health treatment cost him his job. And he's urging Missouri lawmakers to prevent that from happening to others.

Duff suffers from bipolar disorder. During a health examination at the end of his probationary period, he declared his condition -- a disclosure Duff says led to his termination.

He worked in the hydraulic and pneumatic sales department of a Fortune 500 corporation.

"The health insurer said [to the employer] 'If you put him on your plan we have to take the company out of our plan.' This was a clear case of discrimination," Duff said. "Lucky that I was a veteran and got my brain disorder and substance abuse treated at the VA hospital in Kansas City."

After the loss of his job, Duff moved to Joplin in Missouri and started his own construction company.

Duff told his story at a recent public hearing of the House Health Committee that voted Monday night 12-1 approving a bill that would require health insurance policies to provide the same levels of coverage for mental and physical illnesses -- effectively prohibiting insurance discrimination between mental and physical illnesses.

Currently some insurance policies do not cover treatment for mental illnesses or if they do cover it, they have different co-payments or limitations on the treatment.

"We want diseases in all parts of the body to be treated equitably," said Rep. Vicky Riback Wilson, D-Columbia and a cosponsor of the bill. "We should not have an artificial distinction between diseases of the brain and diseases in other parts of the body."

At the public hearing, Ellie Saitta, director of the Boone Hospital's Behavioral Health Center in Columbia seconded Wilson's opinion.

"Health care in general treats body, mind and spirit and the mental parity bill addresses that," Saitta said. "So when we are breaking down the reimbursements into mental and physical health we are not addressing the whole person."

Duff, now a consumer advocate on mental health issues and a member of National Alliance for Mentally Ill (NAMI), told the committee hearing that including rehabilitation program for drugs and alcohol was a must -- as the bill provides.

"If you don't address one when you address the other you are wasting your money," Duff said.

But opponents of the bill warned that adding mental illnesses would raise health care costs, making it unaffordable for employers and individual buyers.

"Many employers will see this as robbing health insurance plans of flexibility and forcing companies and people to buy more health insurance than they can afford," said Kelly Gillespie, a vice president with the Missouri Chamber of Commerce.

According to an official with the Missouri Association of Health Plans - an insurance industry trade group - the increase would range between 2 to 10 percent.

But the House committee heard conflicting predictions from the insurance industry as to the size of the increase.

"Our experience is about 2 dollars per member per month, about 1 percent of the premium," said William Shoehigh, who testified on behalf of United Healthcare.

He said United Healthcare, a full profit-making entity, started offering dual coverage after the federal government brought about a mental health parity legislation in 1997.

Rep. Roy Holand, R-Springfield, sponsor of the bill said that the federal mental parity bill covers self-insured companies, federal employees and those under Medicare. The Missouri bill, he said, goes beyond and covers the rest.

The mental health parity issue has been before Missouri's legislature for several years. It regularly has died after warnings that it would increase the cost of health insurance.

And as for the chances this year, Edward confesses "I am not too optimistic."