For Angela Vickers, the differences that exist in health
insurance coverage for physical health and mental illness send
the wrong message.
"By teaching employers that you can use insurance to
discriminate against people with brain disorders, you teach
society that it is OK," said the 46-year-old Jacksonville woman.
An attorney and mental health advocate who takes Lithium to
treat her own manic-depression, Vickers has little patience for
those who view mental illness as the result of character defects
or bad parenting.
Limiting employees' access to mental health care paves the way
for greater catastrophes, such as hospitalization, that disrupt
jobs, families and lives, she said.
A new federal law that makes it illegal for health plans to
have separate dollar limits on mental and physical health
benefits ought to please her.
As of Jan. 1, when a health plan comes up for renewal, it can
no longer impose a lifetime or annual expense limit on mental
health expenditures, if it does not impose the same limits on
medical and surgical benefits.
For example, until this year, limits such as $50,000 for mental
health coverage and $1 million for physical health benefits were
typical of many insurance plans.
But from the trenches, where Vickers and other advocates sit,
so much more remains to be done: Even the new law does less
than meets the eye.
"Raising the lifetime dollar limit can be illusory," said Andrew
Sperling of the National Alliance for the Mentally Ill. "This
law is not an end. It is a beginning."
The law applies only to employers with more than 50 workers who
offer mental health benefits.
It fails to prohibit many of the techniques now used to put a
firm lid on employees' mental health spending.
Insurers can still require employees to pay higher deductibles
and co-payment fees on visits to doctors and for prescription
And insurers remain free to slap limits on the number of visits
one can make to a doctor, which can achieve the same effect as
The Mental Health Parity Act even allows employers and insurers
to soften the definition of medical necessity when it comes to
providing mental health services, according to the Alliance for
the Mentally Ill.
And, if the law should increase premiums by more than 1
percent, an employer can apply for an exemption. …