Bill to remedy Georgia mental health parity enforcement moves through Gold Dome
A major mental health bill is working its way through the final days of this year’s legislative session. The biggest part of the legislation is the enforcement of parity, meaning insurance companies have to cover mental health conditions on par with physical ones like a broken arm. Mental health parity is federal law, but it hasn’t been enforced in Georgia.
Suicide prevention advocate Roland Behm says for years an untold number of Georgians have been forced to go out of pocket for needed mental health treatment.
“People have bankrupted themselves, mortgaging their house, dipping into their retirement or college savings accounts in order to pay for behavioral health care that is required to be provided by insurers in the first place,” he says.
Since 2008, it’s been federal law to cover mental health care equally with physical health. But enforcement was left up to the states. And Georgia decided not to enforce.
Mental Health Parity Act co-sponsor Republican Rep. Todd Jones says the lack of enforcement meant for years he couldn’t get proper treatment for his son Justin, who’s diagnosed with schizoaffective disorder.
Jones recalls one counselor giving this advice: “And I quote ‘Have him commit a felony.'”
That implied, he says, that prison would be the best option for his son to access proper treatment.
So why hasn’t parity been enforced in Georgia?
“Why not? It’s called politics and greed and profit,” says Jeff Breedlove with the Georgia Council on Substance Abuse. In part, he blames the insurance industry lobby.
“We’ve heard estimates from $250 million to half a billion dollars in profit for greedy insurance companies,” he says. “And that’s money that should have been in the system providing care and service for Georgia families.”
Messages to an insurance lobbyist were not returned.
The state insurance commissioner’s office declined to comment until the bill’s language is finalized. The proposal would make major changes to the enforcement of parity through the office, including creating a new position overseeing compliance with federal law.
Insurance companies would have to provide some data on parity coverage. And patients would have more avenues to appeal claim decisions.
For Republican state Rep. Charlice Byrd, the bill goes too far. She also worries about government regulations — and the price tag.
“It is the largest expansion and regulation of government in Georgia, and premiums will skyrocket due to coverage mandates,” she says.
There’s no clear data showing premiums would automatically go up if parity is enforced.
In a statement, Jesse Weathington, president and CEO of the Georgia Association of Health Plans said this about HB 1013.
“Our health plans are committed to mental health parity and we will continue to work to ensure members get access to the care they need,” the statement to WABE reads.
Rep. Jones says research for the bill points to possible lessons Georgia could take from other states that have enforced parity.
“Some of them, not all of them, have witnessed a single-digit increase in their premiums but then they also then saw a corresponding decrease in their premiums. And the reason why, we believe based on some analysis, has been wellness. We saw that once wellness started to be focused on as opposed to chronic conditions you saw their expenses go down which meant that insurance companies were able to play that across the board,” Jones told WABE politics reporter Rahul Bali at the Capitol.
Helen Robinson with the Carter Center’s Mental Health Program says Georgia could see more savings in the long run, not just for people with private insurance but also for patients on Medicaid who use one of the state’s insurance programs.
“And of course, you’re talking about care management organizations. That’s taxpayer dollars,” she says. “It’s just about making sure that those insurers are providing the coverage that they are expected to provide by law and the coverage they are being paid to provide to Georgians in need.”
The Mental Health Parity Act is estimated to cost the state nearly $30 million. That includes, among other things, costs related to a new loan forgiveness program for mental health providers, more law enforcement training and setting up more crisis centers across Georgia.