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Lawmakers seek to expand mental health coverage

January 21, 1999
By: David Grebe
State Capital Bureau

JEFFERSON CITY - It might be the worst question you can ask in a job interview: "What's the quality of your mental health coverage?"

For many Missourians, mental health coverage might be more comprehensive if some state lawmakers have their way.

A joint legislative committee has proposed imposing a minimum level of mental health coverage on insurance companies and HMOs.

"If you had cancer, you're covered for life, and if you have a disease of the brain you should be covered for life," said Sen. Betty Sims, R-St. Louis County.

Sen. Jerry Howard, D-Dexter, said the purpose of requiring "catastrophic parity" was to protect people from financial ruin. Only employers that already offer mental health coverage will be required to meet the new standards.

"Catastrophic parity" would require that an insurance firm or HMO provide the same life-time limit for catastrophic mental illness as is provided for physical ailments. A catastrophic illness is defined as a long-term, severe condition such as schizophrenia.

Howard said discrimination against mental illnesses creates financial hardship for victims, encourages substandard care, and ultimately passes costs on to the Missouri taxpayer.

People could participate effectively in the labor force if they had access to prompt treatment and medication, according to Cynthia Keele, director of the Missouri Coalition of Alliances for the Mentally Ill.

Some in the business community say they're skeptical about the plan. Although they haven't yet seen it, the Missouri Chamber of Commerce is generally opposed to anything that raises health care costs, according to chamber president Dan Mehan.

Mehan says costs are already rising, and more requirements may lead insurers to drop mental health coverage altogether.

Sims says many major companies already offer equal mental health coverage because it reduces overall health insurance costs. "People come in for fewer headaches and backaches if their mental health needs are taken care of," she said.

The committee estimates that the "catastrophic parity" requirement will add an average $1 per month per employee. Sims points out that companies whose costs turn out to be higher than estimates can apply for an exemption.

Howard says the ultimate goal is to provide full equality between mental and physical illnesses for those insured in Missouri -- but he added that's probably not practical at this time.

"The body is one," Howard said. "There's no reason that Parkinson's, a biologically-based mental illness, should be treated differently than schizophrenia, also a biologically-based mental illness."