Parity of coverage urged

Legislators propose equal coverage of mental and physical ills; insurers say costs will rise.

By David DeCamp, Times Staff Writer
Published March 9, 2008

ADVERTISEMENT [Atoyia Deans | Times] Kathleen Simmons says, "People with mental illnesses are stigmatized." Her insurer limits care.

TALLAHASSEE - First it was her father's terminal cancer, then her marriage fraying apart. Then Kathleen Simmons got sicklast year, spiraling into depression.

That's how the East Lake woman found out her insurance cost more for mental disorders than physical illness.

"People with mental illnesses are stigmatized," said Simmons, 50, suggesting the public stereotypes people with mental disorders as not ill, just unwilling to help themselves.

The plight of people like Simmons made front-page news last week, as Congress tussled once again over a proposal to force insurance plans to cover mental and physical illnesses equally.

The same battle is beginning to play out in Tallahassee before Florida's Legislature. Two Republican lawmakers, one of them a doctor, are pushing the same kind of legislation at the state level.

It's far from certain if Congress will act. Plus, the White House has threatened to veto one version of the plan.

State Rep. Ed Homan, R-Temple Terrace, said that makes it all the more important that Florida's Legislature approves the plan he and Sen. Victor Crist, R-Tampa, are pushing to force health maintenance organizations and group health insurance plans to increase coverage of mental illnesses HB 19/SB 164.

But the outlook in Tallahassee is similarly muddled - for the same reason.

The opposition forces in both Washington and Tallahassee are the same: The insurance lobby and others who worry that raising mental health coverage will inevitably increase premium costs and decrease the number of insured Floridians.

"Nobody - I repeat, nobody - has lost their insurance because of establishing mental health parity," Homan said.

But some insurers and the Florida Chamber of Commerce warn the requirement could raise costs for employers when the economy is rough.

Paul Sanford, a lobbyist for Blue Cross Blue Shield, said his company's health insurance costs for employers have been rising 4 to 12 percent annually. Most of the health plans regulated by the state involve employers of 50 people or fewer - small businesses where profit margins can be narrow, business and insurance lobbyists said.

"When you give health insurance mandated benefits, and on the other hand, you lose more people that would have health insurance, we haven't really accomplished that much," said Sen. Al Lawson, D-Tallahassee, an insurance agentwho was the only opponent in a 10-1 vote on the plan in a Senate Banking and Insurance Committee meeting last week.

The measure has yet to be heard in the House. Homan said he's already considering changes to his bill in hopes of gathering support. Last year, the bill died before it could reach a full vote in the House or Senate.

A Senate staff analysis suggested the Crist-Homan plan would raise premiums 1 to 3 percent because of the added coverage - an average cost of $20 a month more for a family.

Some studies, including onein the New England Journal of Medicine, show overall health care costs could drop because people with mental disorders would get better overall care. That would stop declines into more health problems.

But Sanford suggested any increase is too expensive. "While 1 percent doesn't sound like much, it never sounds like much until you're the one's paying it," he said.

Simmons, who suffers from depression, disagrees. Adistance-learning educator, she has a $60 co-payment for mental health care visits, which is $40 more than her co-payment for her medical doctor. Plus there are othermonthly outpatient treatment costs. She worries she is nearing the limit on those visits. To help her get the treatment she needs despite the limits by her insurance plan, Simmons saiddoctors have signed commitment ordersseven times under the state's Baker Act.

And while lawmakers debate, she waits for $9,000 more in bills to arrive.

Times researcher Caryn Baird contributed to this report. David DeCamp can be reached at ddecamp@sptimes.com or (850) 224-7263.

[Last modified March 8, 2008, 22:42:00]