Tuesday, October 07, 2008

The maddening JOKE of Federal Mental Health Parity: out of pocket Deductibles Went Up 4 surgical/medic./mental hlth/ substance abuse

Marsha V. Hammond, PhD: Clinical Licensed Psychologist, NC

RE: H.R. 6983

October 7, 2008

Dear Representative Patrick Kennedy (Patrick.Kennedy@mail.house.gov):

I appreciated the talk you gave at APA/ Boston. And while MH parity may be an improvement over what was-----actually, scratch that: its not an improvement because the insurance companies have now simply raised the deductibles for everything: surgical/ medical/ mental health/ substance abuse.

I would appreciate hearing from you re: this important matter.

What a grim world we inhabit.


Marsha V. Hammond, PhD


HERE is the Act information, specifically, H.R. 6983: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008

(cut and paste):


"....The parity law prohibits group health plans from imposing limits on inpatient days or outpatient visits and from requiring higher deductibles or cost sharing for mental illness or addiction treatment. These changes will make coverage for mental illnesses and addictions at an equal level as medical-surgical coverage...."

(cut and paste):


"...the financial requirements ....and the treatment limitations applicable to such mental health or substance use disorder benefits are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the plan (or coverage) and there are no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits."

(cut and paste)

BOTTOM LINE: the insurance companies just made money off of American citizens associated with increasing the out of pocket deductible paid in order to get to the 'non-restricted' medical/ surgical/ mental health/ substance abuse benefits!

And they did it one year prior to the actual enactment of this Act!----which means
they are already pocketing the profits from the increased deductibles!


Testimony from child psychologist posting on an APA listserv:

"Parity in Washington turned out to be a joke, and a money maker for the
insurance industry. What it did for my patients was raise their deductible. So prior to parity, their deductible may have been $500 for the year. Now with parity for mental health, their deductible is now $2000 per year. Many can never use their
benefits, as everything is going to deductible. And the deductible is based
on one person. So if you have a family of 4 who all need treatment, it's
$2000 deductible per person, per year. So in January, they start all over
again with the $2000 deductible."



**IF the insurance company experiences an "increase for the plan year involved of the actual total costs of coverage with respect to medical and surgical benefits and mental health and substance use disorder is more than:

‘(i) 2 percent in the case of the first plan year in which this section is applied; and
‘(ii) 1 percent in the case of each subsequent plan year.

the company may opt out of providing mental health parity.


**It does not go into effect for another year (and yet the insurance companies are raising their deductibles already):

Effective Date-
(1) IN GENERAL- The amendments made by this section shall apply with respect to group health plans for plan years beginning after the date that is 1 year after the date of enactment of this Act


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