Mental Health Equal to Medical Reimbursement in North Carolina
NC Senate Votes in Favor of Mental-health Parity - Winston-Salem Journal, James RomoserJuly 05, 2007
Workers with severe depression, schizophrenia or other mental illnesses would be entitled to the same health-insurance benefits as workers with physical ailments under a bill approved by the N.C. Senate yesterday.
Despite some senators' concerns about increased costs to small businesses, the bill was approved by a vote of 36 to 12. It is now being sent back to the N.C. House of Representatives, which previously approved the bill in a different version.
The vote took North Carolina another step closer to a system known as mental-health parity, in which employers' group health insurance plans are required to treat mental illnesses on par with physical illnesses.
Supporters of parity have long tried to get bills through the legislature, but without much luck.
"Mental health parity legislation has been debated by this General Assembly for over 15 years now, and I'm pleased to say that we've reached some common ground," said Sen. William Purcell, D-Scotland.
But while a majority of legislators have now voted in favor of some form of parity, there are still details to be worked out.
The version of the bill approved by the House would require full coverage for all mental illnesses -- except at small businesses with group insurance plans of 25 or fewer people. Those small businesses would be exempt from the bill.
The Senate version would apply to businesses of any size, but it would not require full coverage for all illnesses. It would require full coverage for nine of the most common mental illnesses, but it would allow insurers to place certain restrictions on care for other mental illnesses, such as autism and attention-deficit disorder.
And neither the House nor the Senate version would capture all of the state's workers.
Many large companies are self-insured and would not be affected by legislation requiring mental-health parity because state insurance mandates do not apply to self-insured companies.
Under current state law, group-insurance plans are not required to provide coverage for mental-health care.
The state's largest health insurer, BlueCross BlueShield of North Carolina, was heavily involved in drafting the Senate version of the parity bill, and the company said the Senate version provides sensible mandates.
BlueCross said that the Senate version would cost the company an additional $9.6 million in the first year. That comes out to $1.38 in increased costs per member per month.
Some senators worried the increase would be passed down to businesses already squeezed by rising insurance costs.
"This is just another burden on small business. They have about 48 separate mandates for coverage now, and how much more can we put on them?" said Sen. Robert Pittenger, R-Mecklenburg.
The N.C. Chamber, which represents businesses across the state, opposed the original version of the bill. A spokeswoman for the chamber said yesterday that the revised versions of the bill are somewhat improved, but that the chamber continues to be concerned about increased insurance costs.
"We know that business in North Carolina is already being strangled by the cost of health care, particularly small businesses, and we know that mandates increase costs," said the spokeswoman, Sherry Melton.
Supporters of parity said that it has not been shown to cause large cost increases in many other states. They said that providing more coverage for mental-health issues would actually reduce the state's overall health-care costs, because people would get good care earlier and would be less likely to fall into the public system of mental-health care.
That system has been widely criticized over the past 10 years as being overburdened and under-financed.
Workers with severe depression, schizophrenia or other mental illnesses would be entitled to the same health-insurance benefits as workers with physical ailments under a bill approved by the N.C. Senate yesterday.
Despite some senators' concerns about increased costs to small businesses, the bill was approved by a vote of 36 to 12. It is now being sent back to the N.C. House of Representatives, which previously approved the bill in a different version.
The vote took North Carolina another step closer to a system known as mental-health parity, in which employers' group health insurance plans are required to treat mental illnesses on par with physical illnesses.
Supporters of parity have long tried to get bills through the legislature, but without much luck.
"Mental health parity legislation has been debated by this General Assembly for over 15 years now, and I'm pleased to say that we've reached some common ground," said Sen. William Purcell, D-Scotland.
But while a majority of legislators have now voted in favor of some form of parity, there are still details to be worked out.
The version of the bill approved by the House would require full coverage for all mental illnesses -- except at small businesses with group insurance plans of 25 or fewer people. Those small businesses would be exempt from the bill.
The Senate version would apply to businesses of any size, but it would not require full coverage for all illnesses. It would require full coverage for nine of the most common mental illnesses, but it would allow insurers to place certain restrictions on care for other mental illnesses, such as autism and attention-deficit disorder.
And neither the House nor the Senate version would capture all of the state's workers.
Many large companies are self-insured and would not be affected by legislation requiring mental-health parity because state insurance mandates do not apply to self-insured companies.
Under current state law, group-insurance plans are not required to provide coverage for mental-health care.
The state's largest health insurer, BlueCross BlueShield of North Carolina, was heavily involved in drafting the Senate version of the parity bill, and the company said the Senate version provides sensible mandates.
BlueCross said that the Senate version would cost the company an additional $9.6 million in the first year. That comes out to $1.38 in increased costs per member per month.
Some senators worried the increase would be passed down to businesses already squeezed by rising insurance costs.
"This is just another burden on small business. They have about 48 separate mandates for coverage now, and how much more can we put on them?" said Sen. Robert Pittenger, R-Mecklenburg.
The N.C. Chamber, which represents businesses across the state, opposed the original version of the bill. A spokeswoman for the chamber said yesterday that the revised versions of the bill are somewhat improved, but that the chamber continues to be concerned about increased insurance costs.
"We know that business in North Carolina is already being strangled by the cost of health care, particularly small businesses, and we know that mandates increase costs," said the spokeswoman, Sherry Melton.
Supporters of parity said that it has not been shown to cause large cost increases in many other states. They said that providing more coverage for mental-health issues would actually reduce the state's overall health-care costs, because people would get good care earlier and would be less likely to fall into the public system of mental-health care.
That system has been widely criticized over the past 10 years as being overburdened and under-financed.
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