Bailout may bring relief for parents of mentally ill kids
Rocky Mountain News
Vail, CO Colorado
Finally, some good news for hundreds of Coloradans who are parents of mentally ill children.
Snuck into Congress’s $700 billion bailout law is a measure that forces private health insurance companies to provide equal benefits for mental illness as they do for other types of illness.
It’s controversial, and some say it will bump up insurance premiums across the board. But for family members taking care of someone who is mentally ill, it is a godsend.
“This is huge, a very big thing,” Tammy Snow of Aurora, whose 12-year-old is bipolar and suicidal, said today.
She said that for years she played Russian Roulette with her son’s health and safety, because her insurance’s maximum benefit for mental health wasn’t nearly enough to meet Zachary’s needs.
Like many health plans, her’s allowed a maximum of 20 mental health visits a year, she said.
He needed weekly visits, so she tried to parse them out for when he needed them the most.
“It was like walking on eggshells,” she said. “Do I take him this week” when he is only vaguely suicidal, “or do I want to reserve his therapy for a week when he might have an even worse issue.”
And if he had to be hospitalized, that could eat up most of the yearly benefit, plus require a big out-of-pocket hit.
So, she would balk at bringing him to a hospital.
But then “if I don’t get him mental health care, am I going to get in trouble with Social Services because I let things go?”
Another tough choice: “Do I pay out of pocket instead of paying the electric bill?”
Snow’s salvation was when she married a military man and got government benefits, which include excellent mental health coverage, she said.
But she felt for the hundreds of other Colorado parents who had private insurance that didn’t treat their kids’ serious mental illnesses with the importance of, say, asthma or diabetes.
For those people, the new law could mean not having to ration care.
It certainly isn’t a panacea, though, say advocates for the mentally ill.
For one thing, it only applies to people with private health insurance.
The long waiting lists just to be seen will continue for hundreds of mentally ill Coloradans who don’t have insurance at all, said Lacey Berumen, executive director of the Colorado chapter of the National Association for the Mentally Ill.
If about one in six Coloradans are without insurance, it’s more like one in two or one in three people with mental illness, say advocates.
And serious mental illness symptoms often show up about the time a young person is leaving the parental safety net.
A diagnosis of schizophrenia or bipolar disease often comes in the late teens or early 20s, Berumen notes.
The children might get a couple years of decent therapy on the parents’ insurance, but then after the 18th birthday ” 23 if they’re in college ” the coverage is lost.
If they can’t hold a job, they have no chance for insurance, and little hope of affording the $300-per-month medications that help them function.
Indigent care is a possibility, and the state legislature last year freed up $2 million for that, Berumen said. The need had been identified as $12 million.
The Mental Health Center of Denver served 11,000 people last year, including many without insurance. But every day, they had to turn seven people away, mostly people who couldn’t pay.
“Mental health has never been funded at the level it needs,” Berumen said. “As a result we’ve seen numerous hospitals close.” Just this fall, the University of Colorado Hospital said is was shutting its psychiatric services.
If someone has an acute psychotic episode, he or she might need seven days in a hospital, at a rate of at least $1,000 a day, she said.
“When you’re unemployed and living on the streets, you certainly don’t have that.”
Still, the new law could be a great benefit to those who have private insurance.
Until now, insurers in Colorado only had to provide coverage for anorexia and bulimia on an outpatient basis, Berumen said.
Now, they’ll be required to provide the level of service needed, which for many people with eating disorders necessitates a hospital stay because of the devastation the disorder does to the body, she said.
It also may help give people a second or third chance at rehab for alcohol or drug addiction.
Typically, insurance has been covering just one 30-day visit to rehab for a person addicted to alcohol or drugs.
Experts know that the average person needs about three or four visits for one to finally take hold, she noted.
The Congressional Budget Office estimates that the new requirement will increase health premiums by an average of about two-tenths of 1 percent. Businesses with 50 or fewer employees that offer health benefits don’t have to meet the parity rule.
Among the famous names pushing for mental health parity were Betty Ford, Rosalynn Carter and Tipper Gore.
Leading the fight in Congress was Rep. Patrick J. Kennedy, D-R.I., who says he became the poster boy for addiction and mental health treatment after a bad traffic accident in 2006.
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