BOISE – Idaho is now one of just two states with no requirements that health insurance cover mental illness just as it covers physical ailments. But the state may be ready to take its first step toward providing equal coverage for mental conditions, or mental health parity, say supporters of such a move.
Legislation to try an experiment – providing parity just for state employees, to see how it works in Idaho and how much it costs – cleared a House committee last week and is awaiting a vote in the full House. Similar legislation last year failed in the House by eight votes, but sponsors say this year’s bill has a shot.
“I think we’ve answered a lot of the questions that people had,” said Rep. Kathie Garrett, R-Boise.
Supporters have tried to get parity bills passed in the Idaho Legislature for more than a decade.
In 1998, House Speaker Bruce Newcomb and State Affairs Committee Chairman Bill Deal, R-Nampa, co-sponsored a statewide parity bill, but lobbyists for the insurance and health care industries lined up to oppose it, and it died in committee.
At the time, Newcomb said, “All I know is that I have a strong belief that mental health problems are just as bad as physical health problems, and we cover physical health.”
Since then, increasing numbers of states have adopted parity laws, but Idaho has held out. According to the National Mental Health Association, Idaho and Wyoming are the only states still lacking requirements. In 2005, Washington enacted what the association called a “good parity law.”
Boise resident Mark Seeley, who is bipolar, urged lawmakers to pass the bill even though it wouldn’t apply to him because he’s not a state employee.
“It simply sets an example and says the state of Idaho will lead,” Seeley said.
He said he was told several years ago he might be able to get on federal disability, but he preferred to work.
“We all want the simple dignity of being able to pay our bills,” Seeley said. “For the state and companies and private insurers to make that harder specifically for people with mental illness, I think, is just wrong.”
Seeley isn’t the only one. An array of individuals and organizations backed HB 615 at a two-hour committee hearing last week. In fact, much of the opposition has evaporated, and testimony at the hearing was overwhelmingly in favor of parity.
Lyn Darrington, lobbyist for Regence BlueShield of Idaho, told the House Health and Welfare Committee that Regence is neutral on the bill this year.
“Traditionally health insurers oppose mandates,” Darrington told the lawmakers. But she said the pilot program with state employees is “appropriate,” and will allow her firm and others to see what the costs of parity here really would be. “Good luck to you,” she told the bill’s sponsors.
Only one person – Idaho Association of Commerce and Industry lobbyist Teresa Molitor – spoke against the bill. IACI’s policy on the issue says that parity requirements “interfere with the employer’s and employee’s ability to design individualized, competitive health care benefit plans.”
But Jim Baugh, head of Co-Ad Inc., a group that advocates for the disabled, said that as a small employer he’s been unable to buy a policy in Idaho that will provide mental health parity to his employees because the state doesn’t require that it be offered.
The state’s lack of mental health parity also may be contributing to its soaring Health and Welfare budget. The state is virtually the only payer for people with serious mental disorders. Tom Shanahan, Health and Welfare spokesman, said, “No one knows how to put a dollar figure to that.”
Most people who receive state-funded mental health services have serious disorders and very low incomes, Shanahan said. But if Idaho had parity, those patients could perhaps have gotten treatment before their conditions deteriorated to the point that they could no longer work.
“People would get services when they need them – they don’t have to wait, and they don’t have to keep regressing,” Shanahan said. “Nationally this has been talked about, but no one’s really put a dollar amount on it.”
Rep. Peter Nielsen, R-Mountain Home, an insurance agent, said he hasn’t been able to find policies to sell his clients that offer mental health parity. He asked Rep. John Rusche, D-Lewiston, a physician, why that is.
“Nobody wants to be the first carrier in the field with better benefits,” Rusche said, “because everybody out there who needs that benefit is going to come to you. If everybody’s in the pool, you’re all wet. If you’re the only one that’s wet, it doesn’t work.”
Eight years ago, insurance lobbyists told lawmakers they thought a state parity law would raise their costs by as much as 9 percent. But since then, as other states have imposed parity, those estimates have dropped.
Bob Seehusen, lobbyist for the Idaho Medical Association, distributed copies of a federal study that found that parity increased costs by only 1 percent, when it was implemented by the Federal Employees Health Benefits Program, the largest employer-sponsored health insurance program in the nation.
“We’ve been supporting this for 17 years,” Seehusen said.
Garrett said, “What we’re trying to get at is … care is given to people with mental health issues in the same manner that it is given to people with strokes and diabetes and cancer.”