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The Cost Of
Mental Illness Insurance Parity
 | The cost of paying
for health insurance parity for mental illness has been one the most
hotly debated issues at the national and state levels. Despite
vehement opposition by special interests who have claimed that
parity would break the back of business, multiple studies show
minimal cost impact and that businesses are going ahead with plans
to provide parity to their employees.
1. Background Report: Effects of the Mental Health Parity Act
0f 1996 (March 30, 1999)
- Issued by the Substance Abuse and Mental Health Services
Administration (SAMHSA), results of this national survey showed
that 86 percent of employers who made changes in health plans to
comply with the 1996 Federal law did not make any compensatory
reductions in other benefits because the cost of compliance was
minimal or nonexistent.
2. Parity in Financing Mental Health Services: Managed Care
Effects on Cost, Access & Quality i (July 15,
1998)
- The second in a series of reports to Congress issued by the
National Advisory Mental Health Council found that full parity
costs less than one percent of annual healthcare costs. When
implemented in conjunction with managed care, parity can reduce
costs by 30 to 50 percent.
3. Rand Corporation Study ii (November 12,
1997)
- Equalizing annual limits (typically $25,000) - a key provision
of the Mental Health Parity Act of 1996 - will increase costs by
only about $1 per employee per year under managed care.
- An even more comprehensive change required by some state laws
(i.e., removing limits on inpatient days and outpatient visits)
will increase costs by less then $7 per enrollee per year.
- The main beneficiaries of parity will be families with
children who, under current conditions, are more likely than adult
users to exceed their annual benefit limits and go uninsured for
the remainder of the year.
4. Mercer Study iii (October 23, 1997)
- 85 percent of American companies are either in compliance or
plan to make changes to comply with the Mental Health Parity Act
of 1996 by January 1, 1998.
- Seven out of ten of those same employers agree that mental
health parity is a reasonable national policy goal and that parity
is important to their employees.
5. National Advisory Mental Health Council's Interim Report on
Parity Costs i (April 29, 1997)
- The introduction of parity in combination with managed care
results in, at worst, very modest cost increases. In fact, lowered
costs and lower premiums were reported within the first year of
parity.
- Maryland reported a 0.2 percent decrease after the
implementation of full parity at the state level; Rhode Island
reported a less than 1 percent (0.33 percent) increase of total
plan costs under state parity; Texas experienced a 47.9 percent
decrease in costs for state employees enrolled in its managed care
plan under parity.
6. Lewin Study iv (April 8, 1997)
- In a survey of New Hampshire insurance providers, no cost
increases were reported as a result of a state law requiring
health insurance parity for severe mental illnesses.
7. Congressional Budget Office (June 4, 1996) -
federal cost estimate projected a 0.4 percent increase in premiums
and a 0.16 percent increase in employer contributions for parity in
annual and lifetime limits.
i NAMHC was requested by the Senate Appropriations
Committee, in its report accompanying the 1997 appropriations bill
(Sen. Report No. 104-368) to report on what is known about the costs
of providing equitable coverage for people with mental
illness-particularly those that are "severe and clearly
identifiable, diagonsable, and treatable."
ii Conducted by the UCLA/RAND Center for Research on
Managed Care for Psychiatric Disorders and funded by the National
Institute of Mental Health for and the Healthcare Communities
Project of the Robert Wood Johnson Foundation.
iii More than 300 businesses polled by William M.
Mercer, Inc., one the nation's leading human resources consulting
organizations, for the National Alliance for the Mentally Ill
(NAMI).
iv Mercer surveyed for NAMI 11 of the 18 insurance
carriers and health plans in New Hampshire representing the majority
of covered lives in the state.
The NAMI Family-to-Family
Education Program is a free 12-week course for family
caregivers of individuals with severe brain disorders (mental
illnesses). The course is taught by trained family members.
All instruction and course materials are free for class
participants. |
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