03/29/2007

Forum

Mental health parity should apply in state

BY MARK REINSTEIN

Many of us are familiar with the old medical adage: First, do no harm. By leaving Michigan as one of only eight states without mental health insurance parity law, the Legislature is allowing tens of thousands of state residents to be harmed daily. That harm must stop.

Some entities decry mandating that employer health coverage must include certain items. The mental health parity bills currently before the Legislature don't require that mental health be included. Rather, they establish that if an employer elects to cover mental health, this coverage cannot be singled out for discriminatory restrictions compared to other medical care.

Some entities bemoan rising health care costs in Michigan. As the CEO of a small agency, I am familiar with those increases. But I know they have nothing to do with parity because our state doesn't have it.

Some entities cite guesses made 10 years ago — when few states had parity — to suggest it will cost people jobs, even though there's no evidence from elsewhere in the country that parity law has resulted in job loss.

Not a single one of the 42 states with mental health insurance parity laws has ever repealed such law. Several of those states have expanded their parity laws. When Vermont employers were surveyed a few years after parity enactment there, half didn't even know the law existed.

Under presidential executive order, 9 million federal employees have had parity for mental illness and addiction disorder since 2001. A federally commissioned study of this coverage concluded that it substantially reduced consumers' personal costs, without any significant increase in health plans' overall expenditures.

One of the nation's leading parity actuaries, Ronald Bachman of the Center for Health Transformation, determined that the cost increase attributable to equal mental illness coverage for federal employees has been between 0.24 and 0.87 percent. And the Congressional Budget Office now puts the average parity gross premium increase to group health plans at 0.9 percent, with a net increase of only 0.4 percent.

The minuscule direct cost, if any, that accompanies parity can be more than offset by long-term savings to employers through less absenteeism, increased productivity and reduced use of emergency rooms and other medical care.

There are also cost-benefits to society in not forcing people who otherwise have health insurance to seek publicly funded mental health services.

National business groups, insurers and unions support the version of mental health parity law (which would apply to large employers and is otherwise similar to Michigan's bills) presently before the U.S. Senate. It's time for those interests to support the same protection for all privately insured Michigan citizens.

That's what Gov. Jennifer Granholm's Mental Health Commission called for; what the Michigan Democratic Party convention endorsed February of this year; and what state voters have strongly backed when polled.

Is the anti-parity lobby in Michigan right, while everyone else across the state and country is wrong?

About the author
Mark Reinstein of Ann Arbor is president and CEO of the Mental Health Association in Michigan, a Southfield-based advocacy group.

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