As Director of CCLP’s Health Care program, Bethany works with staff on setting the program’s priorities and leads its advocacy work. Her areas of expertise include regulatory analysis and advocacy for Medicaid and commercial coverage, access to behavioral health benefits, Medicaid eligibility and much more.Staff page ›

Oct 14, 2016

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Coloradans must stand up for mental health parity

by | Oct 14, 2016

Despite recent efforts to address behavioral health issues, the incidence of poor mental health and substance abuse disorder is unacceptably high in Colorado.

Untreated, behavioral health problems impact physical health, school performance, jobs and incarceration rates. Nationally, mental illness affects roughly 20 percent of the population, and substance use disorder affects about 10 percent, but data suggests that Colorado numbers are higher, with a 27 percent increase from 2008 to 2015 in the use of heroin among 18- to 24-year-olds.

Access to mental health treatment is inadequate in large part because stigma and entrenched attitudes about behavioral health have historically resulted in poor coverage. In fact, only 41 percent of adults in the U.S. with a mental health condition received services for that condition in 2015. For African Americans and American Indians, access to treatment is even more limited. In Colorado and nationally, the primary reason people gave for lack of treatment was the misperception such services weren’t covered, and that treatment costs were prohibitively expensive.

This disparity can and must change. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was meant to address the disparity between how illness of the body and illness of the mind are covered in private and public insurance.

The underlying principle of the MHPAEA and recently finalized regulations is that restrictions on access to mental health and substance use disorder treatments should be no greater than restrictions on access to medical and surgical treatments.

Since cost is a primary restriction on access, costs should be comparable for physical and behavioral health treatment. Additional hurdles like prior authorization or fail-first regimens should not be imposed on people seeking behavioral health services.  And higher levels of care for mental health or substance use disorder treatment — like residential treatment — should be no harder to access than time in a skilled nursing facility or physical rehabilitation facility.

State implementation of MHPAEA has only just begun. This year, the Colorado Center on Law and Policy is pressing the Colorado Division of Insurance and the Department of Health Care Policy and Financing to undertake comprehensive reviews of private insurance plans and Health First Colorado (also known as Medicaid) for parity, and to require changes where parity requirements are not met.

This past spring, the Division of Insurance took a major step in the right direction, issuing a regulation on Essential Health Benefits that requires access to residential benefits for mental health and substance use disorder treatment that is on a par with access to similar benefits for medical conditions. Still, too few resources are currently dedicated to this work and we believe that too many obstacles to treatment will remain in 2017.

Those who are covered by private insurance or Health First Colorado (Colorado Medicaid) can play a big part in changing that, by taking action when it appears that parity is lacking.

With help from our national partners, CCLP developed a document that can help identify potential “red flags” in mental health parity and provide information on helpful resources when there’s a problem.

Since good health pertains to the body and the mind, it’s critical to eliminate disparities in how physical and mental health conditions are covered by insurers. After all, it takes much more than sunshine and snow-capped mountaintops to ensure that Colorado lives up to its reputation of being one of the country’s healthiest states.

– Bethany Pray

Recent articles

CCLP Statement on Health and Hospital Corporation v. Talevski

Last term, we watched as the Supreme Court issued rulings that had wide sweeping consequences for individuals across the country. The Court tipped its hat to the second amendment by expanding the ability to carry guns in public while simultaneously decimating the...

New Public Charge Rule is a Victory for Immigrant Communities

Some immigrants who apply for a green card or a visa to enter the United States must pass what’s called a “public charge” test. The test is designed to evaluate whether the person will primarily depend on the government for support in the future, based on factors such...