Mental health “parity” is serious business

Wisconsin is the closest it has ever been to having a mental health parity law.

The Wisconsin Parity Act, which passed the state Senate in late January and is now pending in the Assembly, would require insurance plans to treat mental illness and alcohol and drug addictions the same as other health problems. While past attempts to pass parity have failed, the bill’s supporters believe that with Democrats in control of the Senate and Assembly, the time is right for parity to become law.

The state bill would expand mental health care and substance abuse treatment services to 700,000 Wisconsin workers whose companies are exempt from the federal Mental Health Parity law that went into effect Jan. 1.

The federal law doesn’t require businesses to offer mental health benefits, but if they do – and most large employers do – they have to cover mental illness and substance abuse disorders at levels equal to medical or physical conditions. So for example, an insurance policy can’t charge a patient a higher copay to visit his psychiatrist than it would for a visit to the oncologist’s office.

The Wisconsin law would go a step further by covering more businesses – even firms as small as 10 employees would have to comply. The federal law covers companies with 50 or more workers.

What the parity bill really boils down to is fairness. A person who needs treatment for bipolar disease is no different than a person who needs treatment for heart disease, mental health advocates say.

When it comes to fixing health care, however, there’s no such thing as a fair or simple solution. Opponents of the state’s parity bill – business groups such as Wisconsin Manufacturers & Commerce (WMC) – point out that laws requiring insurance plans to cover a growing list of ailments just makes health care less affordable for everyone.

“These are tough economic times for businesses large and small, but small businesses in particular are having a tough time with rising health care costs,” asserts R.J. Pirlot, legislative relations director for WMC, the state’s largest business lobby group. Pirlot points out that if passed, the Wisconsin parity bill will be the fifth new insurance benefit “mandate” passed this legislative session.

Since April 2009, the Legislature has approved laws requiring insurance coverage for autism, hearing aids and cochlear implants, contraceptives and health care for dependent children up to age 27.

For one Wisconsin business, the tipping point on mandated benefits came with the federal parity legislation. Rather than comply with the law by increasing benefit levels, the Janesville-based grocery store chain Woodman’s has decided to drop mental health and substance abuse coverage for employees.

“We’re just not going to open up our employees’ health care plan and allow drug abusers and alcoholics to run up the costs,” company vice president Clint Woodman told the Janesville Gazette in January.

While Woodman’s frustration with rising health care costs is understandable, you have to wonder what that decision will cost the company and like-minded employers in the long run. According to ParityForWisconsin.org, a website tracking the Wisconsin parity bill, untreated mental illnesses and substance abuse cost U.S. employers billions of dollars a year in lost worker productivity and workers with alcohol or drug problems are 3.5 times more likely to have costly accidents on the job.

Lack of parity also translates into higher local taxes. The Wisconsin Counties Association, which supports a Wisconsin parity law, reports that the largest percentage of county tax revenue for human services is spent on mental health and substance abuse treatment. Meanwhile, county jails are filling up with people who commit crimes while under the influence of drugs or alcohol.

Others who support parity claim the impact on Wisconsin insurance premiums will be minimal. Although the state insurance commissioner’s office is still studying how much premiums will go up under a state parity law, supporters cite the Congressional Budget Office estimate that federal parity is expected to cause premiums to increase just 0.4 percent – a small amount when compared to the cost of not covering such care.

“This (state) bill would eliminate a double standard in health benefits,” says David Riemer, policy and planning director at Community Advocates Public Policy Institute in Milwaukee. “Parity is saying that your insurance can’t apply one standard for physical ailments and another standard for addiction and mental health, both of which have a physiological basis.”

Community Advocates focuses on ensuring that low-income people can find health insurance, mental health care and substance treatment, along with housing and other services. The nonprofit organization is a sponsor of Making Parity Real, a statewide symposium series that supports mental health reform. The latest symposium, scheduled for March 5 in Wausau, called together lawmakers, doctors, hospitals, mental health advocacy groups, public policy and law enforcement officials to discuss how Wisconsin can improve patient access to mental health care. Passing the parity bill is one step. Not taking that step is too great a cost to ignore, Riemer says.

And when you consider that mental illness affects one in four adults and substance abuse affects one in 11, it becomes clear that “making parity real” is serious business for a lot of people.