December 27, 2010

Mentally Health Care Challenged

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Reviewed by: 
Joseph V. Madia, MD By:

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2008 law may result in more insurance providers dropping mental-health coverage for employees

(dailyRx News) A 2008 law requiring health insurance providers to supplement mental health benefits to the extent they cover medical treatment may result in complete loss of mental-health and substance-abuse benefits for some employees.

Some health plans are dropping mental-health and addiction-treatment plans entirely to circumvent the Mental Health Parity and Addiction Equity Act, which was signed into law in 2008 and takes effect for many plans beginning in 2011. Among those shirking mental-health benefits entirely include the Screen Actors Guild (SAG), which covers almost 12,000 enrollees, the Plumbers Welfare Fund (3,500 members) and Woodman's Food Market (2,200 employees).

About a third of companies with more than 50 employees, responding to the Kaiser Family Foundation's 2010 Employer Health Benefits survey, said they plan to implement changes to their mental-health benefits in response to the law, while 5 percent of the firms said they plan to drop those benefits altogether.

Bruce Dow, the chief executive of SAG's Producers Pension and Health Plans, said if mental-health benefits weren't dropped, actuaries estimated costs to double, spiking more than $3 million annually. These costs would arrive in addition to a multi-million-dollar deficit for 2011.

Dow said the union would like to have kept existing programs as they are, but added, "we're not in a position" to cover costs.

Meanwhile, higher premiums and skyrocketing deductibles are costing employees more than ever. Premiums for employer-sponsored family health insurance jumped 41 percent (on average) across states from 2003 to 2009. That figure represents a growth rate more than three times faster than median incomes rose during the same time, according to a new Commonwealth Fund report.

And insurance is covering less, according to the report, as deductibles rose 77 percent on average during that time.

Families with job-based insurance have been sacrificing wages to keep their health insurance for the past decade, said Commonwealth Fund Senior Vice President and lead study author Cathy Schoen, adding the Affordable Care Act (ACA) aims to improve coverage and curb healthcare cost increases in the future.

According to the report, employer-based premiums for family coverage were highest in Alaska, Connecticut, Massachusetts, Vermont, Wisconsin and Wyoming, exceeding $14,000 a year. And by 2009, annual family premiums in the lowest-cost states (Alabama, Arkansas, Hawaii, Idaho, Kansas, Montana, North Dakota, Ohio, Oklahoma, South Dakota, and Utah) ranged from $11,000 to 12,000.

Commonwealth Fund President Karen Davis said if implemented well, ACA provisions can reverse these unsustainable increases. Some of the ACA provisions set to take effect in 2011 include tax credits for small businesses to provide coverage, the elimination of co-pays for preventive care and the age extension in young adults' coverage, who can remain eligible for dependent care until age 26.

As far mental health coverage, Terry Musto, administrator of the Plumbers Welfare Fund, said he hopes to reinstate benefits as the economy recovers.

Dow said that the SAG's Producers Pension and Health Plans will begin working with members to refer them to community-treatment options for prescription drugs such as antidepressants when the pension drops mental-health coverage for 11,644 participants next year.

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Reviewed by: 
Joseph V. Madia, MD
Review Date: 
December 27, 2010

Last Updated:
January 5, 2011