Yesterday marked a major milestone in a fight waged by eating disorders advocates and allied mental health advocates. The breakthrough came when the Obama administration issued rules that will govern parity in mental health benefits and treatment. This means that at last mental illnesses must be covered just as physical illnesses are. The ruling applies to all existing forms of health insurance plans, and steps are being taken to extend it to those covered under President Obama’s Affordable Care Act.
For eating disorders patients, The Mental Health Parity and Addiction Equity Act of 2008 means easier access to coverage. Until now, getting coverage has often meant protracted fights with insurers, testifying before medical directors to prove need, or capricious and arbitrary turn-downs that delayed or ruled out treatment prescribed by eating disorder specialists. Lack of transparency, or information on how denials were arrived, has been another issue.
Now, rules governing co-payments, deductibles and limits on visits to mental health providers must be equal to those for medical and surgical providers and services.
The history of the mental health parity act goes back nearly two decades to Senators Paul Wellstone (D-MN) and Pete Domenici (R-NM), who followed the lead of First Lady Rosalynn Carter and spearheaded a bipartisan effort to advance a mental health and addiction parity act.
Wellstone’s son, David Wellstone, and First Lady Carter were on hand in Atlanta, where the announcement of the breakthrough was announced.
Insurance companies must now provide consumers with information on how they determine coverage and what standards they used to evaluate claims. The newly issued rules also clarify how parity applies to intermediate levels of care such as residential treatment and outpatient services, where many facing eating disorders, addictions, or other mental illnesses are treated.
Longtime eating disorders advocate and director of the Emily Program Foundation Kitty Westin told the minnpost.com, “I am excited, I have been waiting for this,” noting that she had worked with Wellstone before his death in a plane crash, and continued working with his son on the bill.
“My narrow issue is eating disorders,” Westin was quoted as saying. “My wider issue is making sure that people with mental illness have access to the care they need. We really wanted to make sure that people with eating disorders would benefit from whatever parity bill passed.”
Advocates realize, however, that their job is by no means over. In The New York Times, Carol A. McDaid, the leader of a coalition of patients and providers of mental health and addiction services, was quoted: “This is the beginning, not the end, of our work to make the vision of the law a reality. We have to make sure that the law and the rules are fully enforced.”
On the website of the advocacy group Eating Disorders Coalition there is a link to a C-Span clip of former Representatives Patrick Kennedy (D-RI) and Jim Ramstead (R-MN), both strong supporters of the legislation, made long before yesterday’s rules were announced.
Foreseeing the day when the legislation would become reality, Kennedy noted that even when that day arrives, “We need to be vigilant…we are going to have to keep standing up [for it]…because that’s the way life is. We need people to get involved, and stay involved.”