Pro: End discrimination against the mentally ill End discrimination against the mentally ill

Discrimination continues against the mentally ill in Washington state. They face an unjust societal stigma, while battling health-insurance discrimination that severely limits access and treatment for their mental illnesses.

For thousands of people in our state, health-insurance plans impose higher co-payments, fewer treatment days and visits per year, and/or higher deductibles for mental illnesses than for physical-health problems. That is unfair and discrimina-tory.

The chances are great that you have or someone you know has been diagnosed with a mental illness. One in five Americans experiences a diagnosable mental illness every year. According to the World Health Organization, mental illness tops all other diseases as a cause of disability in the United States, accounting for 25 percent of all disabilities. Yet, less than one-third of adults and one-half of all children with a diagnosable mental illness receive the treatment they need in any given year.

Mental health is essential to a person's overall health; they cannot be separated. That is why mental-health treatment improves health outcomes for people with heart disease, chronic pain, diabetes and cancer.

Health-insurance policies, however, distinguish between mental-health and physical-health benefits, and the mentally ill suffer as a result. Many individuals and families throughout our state experience financial ruin due to medical bills from expensive treatments associated with mental illness.

How will parity legislation benefit the mentally ill and their families? "Parity" means health-insurance policies must cover mental-health services in a manner comparable to other health services. It means health insurers must provide the same annual or lifetime dollar limits, co-payments, deductibles, coinsurance, out-of-pocket maximums and day/visit limits for mental-health services as for other health services. Sadly, almost all health-insurance policies in Washington state contain arbitrary treatment and financial barriers to mental-health services.

How will parity legislation benefit Washington's businesses? In 1999, the U.S. surgeon general estimated the direct business cost due to the lack of parity was at least $70 billion per year. The costs businesses incur as a result of absenteeism, lost productivity and increased claims for disability and unemployment insurance due to untreated mental illness are greater than the cost of providing mental-health parity. Numerous national corporations voluntarily provide mental-health benefits comparable to other health benefits because they are convinced doing so is essential to their corporate bottom lines.

At least 33 states have enacted legislation providing some form of mental-health parity, but Washington state is not one of them.

What is being done in our state to end discrimination against the mentally ill? For the past eight years, mental-health parity legislation has been prepared and lobbied for by the Washington Coalition for Insurance Parity. In the 2005 session, mental-health parity legislation has been introduced on behalf of every individual and family that is or may one day be struck by mental illness.

Last year, the same parity legislation passed the House of Representatives with a bipartisan majority of 64 to 33. The Republican-controlled Senate, however, let the bill die in the Ways and Means Committee. This year, the House passed the parity bill by a large bipartisan vote of 67 to 25. With a strong commitment from Senate leaders, and Christine Gregoire as the new governor, the 2005 session looks promising for parity legislation.

The proposed parity legislation includes a number of provisions to minimize costs: The parity requirements would be phased in over five years; treatments must meet the medical-necessity criteria established by each health plan's medical director; and the legislation would not apply to Medicaid, the individual insurance market, or small businesses of 50 or fewer employees.

You may be thinking this is another case of "feel good" legislation that will cost too much. The numbers, however, tell a different story. With appropriate care management, mental-health parity results in less than a 1-percent increase in health-insurance premium costs. Many states — including Alaska, Maryland, Minnesota, New Hampshire, North Carolina, Rhode Island, South Carolina, Texas and Vermont — have documented premium increases of less than 1 percent after implementing comprehensive parity.

We expect our state will do even better. In November 2004, an actuarial analysis prepared by Ron Bachman of PricewaterhouseCoopers concluded the legislation proposed by the insurance-parity coalition would increase health-insurance premiums by less than one-half of 1 percent in Washington state.

Enacting mental-health parity legislation will be a win-win situation for the mentally ill, their families and their employers. The Legislature has a duty to end insurance discrimination against thousands of mentally ill persons. Enacting parity is simply the right thing to do.

Rep. Shay Schual-Berke, D-Normandy Park, and Sen. Pat Thibaudeau, D-Seattle, are sponsors of the mental-health parity bills currently in the Legislature. Randy Revelle is chairman of the Washington Coalition for Insurance Parity and a vice president of the Washington State Hospital Association.