PREVENTATIVE PARITY

An account of expected savings from a mental health parity bill arrived at the Legislature’s Banking and Insurance Committee just after the committee voted 7-6 against funding even a portion of the bill. The new data should give the full Legislature reason to consider this bill, LD 1627, seriously and to ask whether even more savings are possible.

It wasn’t the committee’s fault that the information about savings in the state budget through earlier treatment of mental health wasn’t available until recently. It asked about the savings months ago, but the administration was slow to respond. Now that it has, lawmakers should review the following: The Department of Human Services, which oversees the state’s Medicaid money, concludes it would save hundreds of thousands of dollars in the next year, and tens of millions over the following biennium if a mental-health requirement were passed.

The minority version of LD 1627 has been pared back to require coverage of mental illness only in the large-group market. It is estimated that the coverage will cost policyholders an additional four-tenths of 1 percent ($3 a month, on average), or something less than the rounding error in the typical contract increases. The bill includes coverage of residential treatment facilities and home health services and prohibits exclusion of mental health and substance abuse benefits because of a pre-existing condition for the market it covers. As important, it erases the false distinction between the treatment of physical and mental health.

There are excellent medical reasons for doing this, for those concerned only with the effect on cost, a federal study not long ago looking at the mental health benefits at American Airlines, AT&T, Delta Airlines, Eastman Kodak, General Motors and IBM came to some interesting conclusions. According to a report by the Washington Business Group on Health, the “employers provide general mental health and substance abuse benefits to the employees and their families because they are convinced that doing so is essential to the corporate ‘bottom line.’ … The costs of providing appropriate treatment for mental and addictive disorders must be measured in the larger context that also considers disability costs, employee absenteeism and lost productivity. Taking these into consideration, employers found that traditional benefit limitations were not cost-effective.”

There’s no mystery to the savings in extending coverage: Compare the cost of alcohol-treatment counseling vs. treatment for liver disease. Less obviously, the Maine Health Management Coalition two years ago reported that the link between physical and mental health suggests treating depression may reduce the amount (and cost) of physical illness.

Gov. Angus King was right during his State of the State speech last January when he observed that preventing major illness was essential to reducing health care costs. The governor suggested better diet and exercise, which makes sense as preventive measures in many cases. LD 1627 is access to preventative medicine that eating vegetables and jogging won’t provide. It is affordable now and should produce major savings long-term. It merits support from both the full Legislature and the governor.