National Tour Keeps Focus on Parity-Law Rollout

Former members of Congress Patrick Kennedy and Jim Ramstad, along with the Parity Implementation Coalition, of which APA is a member, are hosting a series of public forums titled “Parity for Patriots Tour” across the country. The goal of the forums is to discuss the implementation and enforcement of the Mental Health Parity and Addiction equity Act of 2008. The tour is a follow-up to 2007 congressional hearings that helped get the law enacted.

The parity law requires that mental health coverage, including for addiction treatment, in employer-sponsored health plans be treated equally to that for other medical conditions. The law does not mandate coverage for mental health and addiction care, but if it is included in a company’s health plan, insurance companies must provide parity coverage. And now, with the Supreme Court’s decision to uphold the Affordable Care Act (ACA), parity’s reach will be extended, benefiting many more mentally ill individuals when all the law’s provisions are in place. For example, coverage of mental illness, including substance abuse disorders, is required as part of the “core benefits” package in the state insurance exchanges established by the ACA.

Kennedy and Ramstad, who acknowledge that they are in recovery from psychiatric disorders themselves, sponsored the legislation in the House and are forceful advocates for full implementation.

At a public forum in Maryland last month, witnesses, along with past and current members of Congress, discussed parity and the implementation and, more importantly, the enforcement of the law. Reps. Chris van Hollen (D-Md.), Jim Moran (D-va.), and Paul Tonko (D-N.Y.) were among the speakers.

More than 200 people gathered as three panels discussed the problems and setbacks in implementing the Mental Health Parity and Addiction equity Act. Experts from various professional fields, including medicine, law, the insurance industry, and government all made the case for stricter enforcement of the parity law. Panelists and witnesses also told personal stories of fighting with insurance companies over parity-related issues. The current and former members of Congress also discussed, from the legislative perspective, progress and plans of action needed to get the law fully implemented.

Kennedy opened the floor for discussion by relating parity rights to civil rights. “We are hoping to find the Rosa Parks of parity,” he emphasized.

Anne Price, a career flight attendant who suffered from alcoholism and posttraumatic stress disorder (PTSD) after the 9/11 attacks, explained her struggle to get her insurance company to cover her addiction treatment. She voiced her frustration with the insurance company’s “fail first” policy and the paperwork ordeal she has endured while pursuing appeals against the company’s rejection of her claims.

Another witness, Adrian Nelson, an Iraq combat veteran with PTSD, discussed the extensive waiting period for treatment through the Department of Veteran Affairs, as well as his self-medication with alcohol and challenges of living with PTSD. He said he hesitantly agreed to appear at the forum after fellow veterans asked him to speak on behalf of all veterans who don’t have the opportunity to do so. Nelson spoke about the stigma associated with people knowing about his PTSD diagnosis, voicing concern about PTSD interfering with future jobs and the effects of PTSD on day-to-day activities such as driving and being in large groups at social gatherings.

A common theme among the panelists fighting over coverage for their mental health treatment was the “fail-first” policy that the insurance companies have adopted. Such policies require the patient to fail outpatient treatment before the insurer will cover hospitalization or other inpatient treatment. Several panelists expressed concern and frustration with fail-first policies, claiming that insurance companies are “gambling with [patients’] sobriety and addictions.”

Moran bolstered testimony of the witnesses, stressing that “This is not a matter of overcoming by willpower. Mental disorders are real, treatable medical conditions.” Kennedy and Ramstad’s goal in conducting these forums is to raise awareness and put pressure on lawmakers to adopt stricter enforcement and broader implementation for the mental health parity law.

The Parity for Patriots Tour will be hosting public forums in several locations throughout the country including in St. Paul, Chicago, Los Angeles, New York, and Delray Beach, Fla.