Study Shows Mental Health Coverage Would Not "Break the Bank"

Providing an equivalent level of insurance coverage for mental health and general medical care would not significantly increase total spending on health care, according to a study by Yale School of Medicine researchers.

“Comprehensive parity under a managed care system would have little effect on total spending,” said Colleen Barry, assistant professor of health policy in the Department of Epidemiology and Public Health. “Opposition to parity on the basis of increased total spending on mental health coverage no longer constitutes an evidence-based objection.”

Barry and her co-authors reviewed two eras of economic research on mental health insurance. The first covered the 1970s and 1980s prior to introduction of managed care. The second era includes data going forward from the mid-1990s.

“Evidence from the first era supported employers’concern that covering outpatient mental health parity would break the bank,” she said. “In contrast, the managed care studies indicate that enactment of full parity would not significantly increased total spending and would protect families against financial risks associated with mental illness.”

Private insurance health plans often require substantially higher cost sharing, deductibles, special annual inpatient day and outpatient visit limits for mental health care compared to other medical services. Consumer advocates challenge unequal coverage as discrimination against persons with mental illness.

Barry, lead author of the study in Health Affairs, said parity in mental health benefits will help to rectify this unfairness. While the 1996 Mental Health Parity Act prohibits insurers from placing special annual or lifetime dollar limits on coverage for mental illnesses, the law does not apply to other benefit limits such as special annual inpatient day limits, outpatient visit limits or higher cost sharing.

Efforts to enact a more comprehensive parity law have stalled in Congress for the last few years, she said.

Co-authors are Richard Frank and Thomas McGuire of Harvard Medical School.

Health Affairs 25: 623-634 (May 9, 2006)

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