HARTFORD – Advocates say passage of 2019’s Mental Health Parity bill represented great progress in the battle for increased mental health access and insurance coverage for those afflicted throughout Connecticut, but it’s not enough.
That’s what state Rep. Sean Scanlon, co-chairman of the Insurance and Real Estate Committee, stressed at a press conference Tuesday when he introduced five additional bills to address disparities in insurance coverage for mental health-related issues.
“There’s no such thing as one silver solution to this issue,” he told the gathering.
Mental health parity requires insurance companies to cover mental health and substance use disorder at the same level as physical ailments.
An estimated 25% of Connecticut’s residents are said to be suffering from what could be diagnosed as mental health conditions; whether it be anxiety, depression, bi-polar disorder, or substance abuse issues, among others. In terms of the impact of addiction disorders, state Sen. Matt Lesser, the committee’s other co-chair who spoke at the press conference, noted that Connecticut ranks 10th in the nation in overdose deaths.
Yet according to a recent study by Milliman Inc., individuals with behavioral health conditions are far more likely than those with physical health conditions to use higher-cost, out-of-network care.
Connecticut was shown to be the worst state in the nation in terms of parity compliance, with 34% of mental health office visits considered to be “out of network,” compared to only 3% for medical office visits.
Some committee members believe House Bill 5256 will address the inadequacy of current health insurance policies in providing coverage for detoxification and substance abuse services. The bill aims to put doctors and experts in charge of determining the length of a patient’s stay at inpatient treatment facilities instead of insurance providers.
Parents Tony and Tracey Morrissey of Milford know this struggle all too personally. Their son, Brian Cody, died from an accidental overdose in August 2019, merely days after he was abruptly discharged from a treatment center where he’d been staying.
“He called us crying, explaining that he knew he wasn’t ready to leave after just 28 days worth of treatment, yet his request was denied by the insurance provider because apparently he overstayed his welcome or ran up too high of a bill,” Tony Morrissey somberly recalled. “We need to make sure that insurance companies are not making decisions about our children, brothers, sisters.”
Jerry Schwab, president and CEO of the nonprofit High Watch Recovery Center in Kent, echoed the frustration. As an experienced caregiver and recovered addict himself, Schwab stressed the importance of reaching 90 days of inpatient treatment as a real benchmark for overcoming the threat of relapse that afflicts so many suffering from substance abuse.
An overhaul in this decision-making process for detoxification and substance abuse services would allow providers “to cover people who need to be in the hospital, need to be in a supervised setting where they can allow this chronic brain disease to cool down and take advantage of different types of treatment available,” Sheila Cooperman, President of Connecticut’s Psychiatric Society, emphasized.
Adoption of House Bill 5254 would require health insurance coverage for Medication-Assisted Treatment (MAT) for opioid uses or disorders.
With a record 1,200 opioid overdoses last year – an 18% increase over 2018 – Connecticut cannot wait any longer to pursue new solutions, Dita Bhargava, a former candidate for CT Treasurer who lost her son to an overdose in July of 2019, argued passionately.
“It is imperative that the State of Connecticut has legislation that guarantees treatment of opioid use disorder (OUD) with medication assisted treatment which can consist of methadone, buprenorphine (Suboxone) or naltrexone, Dr. Steven C. Wolf said in uploaded testimony.
Currently, there is no standard of treatment for opioid-related cases and there is a wide variance in which, if any, of the three aforementioned MAT drugs are carried by doctors or covered by insurance.
“All 3 act differently and may suit one person’s recovery more than another’s,” Bhargava stated. “The one option that we know could help save his life (naltrexone) that he was open to, we were unfortunately denied coverage for time and time again.”
Bhargava described how she was instead presented with the option of paying $1,000 out-of-pocket per shot, which was simply unaffordable.
Scanlon and Lesser hope expanding insurance coverage on medication-assisted treatment programs and encompassing all FDA approved medications will make a big dent in reversing this recent, troubling, trend of opioid overdoses in Connecticut.
“Those in medicat[ion]-assisted treatment programs experience dramatic improvements while both in treatment and for several years after, with decreases in narcotics use and deaths and increases in employment and marriage,” Bhargava concluded.
Those opposed to the bill proposals argue that Connecticut cannot afford to increase its healthcare expenditures per enrollee, as they are already 6th highest in the country.
In testimony against HB 5254 and HB 5256, Michelle Rakebrand, assistant counsel for the Connecticut Business and Industry Association (CBIA), argues the additional health mandates incorporated in these bills “pose an enormous cost to all Connecticut residents.”
“Each year Connecticut residents pay an additional $2,085.48 in premium costs because of the 68 health benefit mandates that are codified,” Rakebrand wrote.
She also said increased premiums would be particularly harmful to many of Connecticut’s smaller businesses, who list healthcare costs as their top concern as they already cover an average of 76% of premiums on their employees behalf through cost-sharing.
Rakebrand further said 95% of the CBIA’s 1,000-plus member companies are small businesses with 100 employees or less, leading her to conclude that “the cost outweighs the benefit being realized.”
She also called for a renewal of Connecticut’s Health Benefit Review program, enacted in 2009, to allow the state’s Insurance Department to conduct a cost-benefit analysis of any proposed mandates.
“The business community looks forward to working with this Committee in an effort to lower healthcare costs, while maintaining the highest quality of care,” Rakebrand concluded.
House Bill 5247 aims to reconcile the difficulty faced by many young adults – who are covered by their parent’s health insurance policy – when they discuss intimate topics like substance abuse or mental health.
According to Healthcare Advocate Ted Doolittle, many young people are uncomfortable seeking professional help or guidance because they are afraid of how their parents – the policyholders – will react when they find out. Under HB 5247, correspondence regarding such topics with doctors or professionals for those 18 or older would be treated with confidentiality, much like colleges refusing to share grades with inquiring parents.
Doolittle said that the topic of addiction is taboo in many families, preventing discussion, and as such perpetuates the nature of the problem as a silent illness for an addicted youth.
Senate Bill 205, also proposed at the press conference, would mandate that travel insurance policies cover death by suicide as a reason for cancellation of a trip.
House Bill 5248, would establish a task force to study health insurance coverage for peer support services in this state.