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Illinois has the best mental health and addiction parity laws in the country.
That is the conclusion of a recent state-by-state report released by the Kennedy-Satcher Center for Mental Health Equity.
On a mission to highlight the best practices for the advancement of mental health equity, the Center gave each state a letter grade on their state statutes.
Illinois received the only “A” grade for mental health parity for having a “strong implementation of its newly enacted parity statute.”
No state got a “B.” Tennessee, Maine, Alabama, Virginia, Colorado, and New Hampshire each got a “C.”
A total of 32 states got failing grades. Two big states, California and Alaska also got an “F” with 55 and 43 out of 100 points, respectively. Wyoming, Arizona, Idaho ,and Indiana received the lowest scores.
Georgia didn’t do that great either, the stated was given a “D.” “Our state rating of ‘D’ reflects the barriers to care that exist in our state for individuals experiencing mental illness and addictive diseases,’’ said Kim Jones, executive director of the Georgia Chapter of the National Alliance on Mental Illness.
There are four drug overdose deaths in Georgia every day, said Neil Campbell, executive director of the Georgia Council on Substance Abuse.
“It is a shame that insurance companies are not recognizing there is a law and, more importantly, a need for the quality and amount of coverage that is afforded physical health conditions,’’ Campbell said.
The cards are meant to raise awareness among state regulators and insurers, as 2018 marks 10 years since President George W. Bush signed the Mental Health Parity and Addiction Equity Act (MHPAEA).
The Act asks health plans that offer both medical and mental health or substance use disorder benefits to offer those benefits in parity.
What does that look like?
On a plan with parity, if a patient with heart disease gets unlimited visits to a cardiologist, he would also get unlimited visits for a mental health condition such as depression.
As Illinois Department of Insurance Director Jennifer Hammer puts it, “that means when you go to the doctor, your copays need to be the same, the quantitative limitations have to be exactly the same.” Hammer went on explaining that “you can’t pay $40 for a visit for mental health and only $20 for a physical health visit.”
Health plans that must follow federal parity include Medicaid Managed Care Plans (MCOs) and group health plans for employers with 51 or more employees. On the other hand, Medicare Medicaid fee-for-service plans or plans that were created and purchased before March 23, 2010 are absolved of complying with the Act.
Here’s the catch, though.
Parity only ensures equal coverage; it doesn’t necessarily guarantee quality coverage. More limited health plans have less comprehensive mental health benefits.
While the state got the highest score, the analysis shows there’s still room for growth: “Parity remains elusive for many individuals directly impacted by mental illness and substance use disorders. They are denied care when they need it most and have few resources to advocate on their own behalf.”
According to the report card, one in six Illinois residents have a mental illness and one in seven are uninsured. What’s more, one in 13 youth have a mental disorder, but for the same number of people on private health plans, mental benefits are not available.
On a positive note, 51% of Illinoisans are covered by employer-based health insurance, a little over the national average of 49%.
“The Kennedy-Satcher assessment score is a clear indicator for our progress. There is more work to do and our teams are working together to make more advances in these important areas of public health,” said Gov. Bruce Rauner.
As rates of suicides and overdoses continue to climb, the Federal Parity Law of 2008 protects mentally ill people from facing discrimination from insurers. In many states, the law is still being poorly implemented. Indiana for example got only 38 out of 100 points or the equivalent of an “F” for not monitoring and enforcing the law properly.
Illinois’ grade is not a fluke. Legislators and patients advocates have been working together to expand access to mental health services. Take for example the recent bill signed by Gov. Bruce Rauner.
Senate Bill 1707 improved the coverage of Illinois’ parity laws, as part of a larger effort to address the state’s opioid crisis. The legislation also prohibited exclusions of the medications for substance abuse ordered by a court for an inmate. “After enactment of SB 1707, Illinois now has the strongest mental health and addiction parity law in the country,” The Kennedy Forum of Illinois Executive Director Cheryl Potts said.
One step that helped consolidate the state’s position as a leader in quality mental health services?
Illinois recently became the only state in the nation to change its essential health benefit (EHB)-benchmark plan.
The new plan includes measures not only to improve mental health service, but also to fight the opioid crisis. The Illinois Department of Insurance consulted clinicians and researchers, and got feedback during two public comment periods before deciding what changes to make to the old plan.
Their list of revisions includes tele-psychiatry care by both a prescriber and a licensed therapist, a sign that Illinois is getting ready for the digital healthcare era. Another boon of video-based psychiatric services? They will bring major savings to the state budget by reducing trips to the ER, the need for time off work and for childcare services.