9/29/00

Holt Leads State House Roundtable On Mental Health Coverage

Trenton - Rep. Rush Holt (D-12th District) led a roundtable discussion at the State House Friday urging that those suffering from mental illness get the same kinds of health insurance coverage afforded people suffering physical illness.

"I've been focusing on improving and expanding health care, and I strongly support a patient's bill of rights, greater negotiating rights for doctors, and a real prescription drug benefit under Medicare. But it is also important to consider the aspects of current law that need to be improved such as the need for mental health parity," Holt said. "Persons hospitalized repeatedly for mental health services can quickly exhaust their typical lifetime health insurance limits-often as little as $50,000 compared to $1 million for other illnesses. While we are all anxious to expand health care coverage, we need to act to improve the coverage that people do have and to treat all illnesses equally."

Holt has cosponsored three bills on the issue: H.Con. Res. 243 expressing the sense of Congress regarding the importance of mental health awareness, mental disorders, and early detection of mental illnesses to facilitate entry into treatment; H.Res. 163, expressing the sense of the House of Representatives with respect to postpartum depression; and H.R. 2945, amending the Social Security Act to provide for the coverage of marriage and family therapist services under part B of the Medicare Program.

Under most health insurance plans, coverage for mental health services is more restrictive than for physical illnesses and services. The number of covered days in a hospital, the number of covered office visits, and coinsurance reimbursement are all usually less, and annual maximum out of pocket protections are generally higher, for mental health coverage.

According to a 1995 survey, hospital days for medical care typically covered 365 days per year, whereas for mental health care, only 30 days was typically covered. Outpatient visits for medical care are usually unlimited while outpatient visits for mental health care were limited to about 20 per year. For other forms of medical care, insurance reimbursement is about 80 percent, while mental health reimbursement is usually lower, about 50 percent.