Bill seeks expansion of health benefits
Mental issues focus of change
Consumers would have greater access to mental health care and substance abuse treatment under a proposed law that is drawing heat from business and insurance groups that say the measure is too costly and violates the state's landmark healthcare law.
The proposal, slated for debate in the House tomorrow, would lift limits on hospitalizations and outpatient treatment for dozens of maladies, such as eating disorders, post-traumatic stress, and drug addictions. Supporters say the measure would ease the stigma on mental illness and allow patients to receive much-needed treatment.
"Unfortunately with a lot of these folks, they don't receive treatment they desperately need and end up costing more to society in other areas, in emergency room visits and lost wages," said Toby Fisher, policy director at the National Alliance for the Mentally Ill of Massachusetts.
The alliance joined 20 other health groups in a recent letter to House Speaker Salvatore F. DiMasi urging passage of the bill, which is sponsored by Representative Ruth Balser, a Newton Democrat, and Senator Steven Tolman, a Boston Democrat.
Yesterday, a coalition of business and insurance groups also sent a letter to DiMasi saying the bill would disproportionately hurt small employers at a time when they are struggling with rising healthcare costs.
Current law divides mental health insurance coverage into two categories. The first group treats certain illnesses, such as schizophrenia, paranoia, bipolar and obsessive-compulsive disorders, in the same way as other health issues, such as cancer, allowing treatment as medically needed. The second group includes other mental health illnesses, such as eating disorders, and limits treatment to 24 outpatient sessions and 60 days of hospitalization per year. The proposed bill would eliminate the distinction between the two groups and would require that all disorders receive the same coverage.
"One disorder not covered fully is addiction, yet one in 10 people in Massachusetts suffers from addiction," said Balser, a clinical psychologist. "We want to make sure people get the coverage they need and deserve."
But critics say expanding coverage before the state understands the full costs of its two-year-old healthcare law would be a mistake. The law has resulted in new coverage for 355,000 residents - a success that is now stretching state funds. Additionally, opponents say, the political compromise that underlies healthcare reform included a moratorium on any new state-mandated health coverage until the state's Division of Health Care Finance and Policy reviewed the costs and impacts of existing mandates. That report has not yet been issued.
"We don't understand why the advocates are pushing this before the report comes out," said Dr. Marylou Buyse, president of the Massachusetts Association of Health Plans, which represents most of the state health insurers.
"This is the worst time to pass a law like this," Buyse said. "Healthcare cost [increases] are double-digit right now and passing a new mandate is going to add to the cost of healthcare reform and runs counter to the effort to control costs."
None of the groups opposing or supporting the expanded mental health coverage was able to provide concrete data yesterday on how much the added coverage might cost.
Kay Lazar can be reached at klazar@globe.com.
