Monday, November 21, 2011

use your voice -Action Alert

EDC asks you to use your voice to make sure eating disorders get included in insurance coverage

If you haven't already: Please submit your comments today!

Deadline has been extended to November 30th


A key component of the Affordable Care Act (ACA) is the requirement that all insurance plans offered through the exchanges must cover, at a minimum, a number of Essential Health Benefits. Mental health is one of these Essential Health Benefits (EHB) that must be included.

The Department of Health and Human Services (HHS) is tasked with promulgating regulations for how the EHB will be designed and implemented. The EDC is asking HHS to incorporate three recommendations into the EHB: 1) eating disorders should be specifically listed in the EHB, 2) all levels of treatment including residential treatment, as recommended by the APA Guidelines, should be part of the EHB, and 3) the definition of medical necessity should be broad and inclusive so that insurers cannot assign medical necessity at random.

Please add your voice by sending comments to HHS ) you urge them to support these above 3 recommendations and 2) some of your personal experience that underscores why these recommendations are important. For example: maybe you personally benefited from successful residential and/or other treatment ---include that in your comments. If you were denied residential and/or other treatment ---include that, and the consequences of being denied, in your comments. And include anything else about your experience or expertise that underscores the need for these 3 recommendations. We know that personal stories matter to HHS.

TO SUBMIT A COMMENT, send your email to:

Please then send an email to to inform us that you sent your comments.Thanks so much for taking a few minutes out of your day to make an important difference. Together we will improve the lives of those suffering from eating disorders!

Here are some additional talking points the EDC has made:

In response to the Department’s stated questions:
In terms of how to best balance comprehensiveness of included in essential health benefits and affordability; we believe that:
o Ensuring access to comprehensive specialized eating disorder care, across all levels of care including outpatient, intensive outpatient, partial hospitalization, residential, and inpatient, will allow individuals to access adequate, effective, evidence-based care in specialized settings, and decrease their need to access less specialized, less effective, more emergent medical and psychiatric care. Decreasing use of high-cost emergent and/or on-going use of inadequate care will balance comprehensiveness and affordability. Eating disorders have the highest mortality rate of all psychiatric illness. Including comprehensive eating disorders treatment in EHB will safe lives.
In terms of how the Department might ensure that essential health benefits reflect an appropriate balance among categories; it is important for the Department to know that:
· Eating disorders affect up to 25 million Americans, across all age, gender, SES, and ethnicity groups. Ensuring access to treatment will have an appropriate balance across the population of sufferers, many who, without adequate access to specialty care would unduly access inappropriate, inadequate, but costly, care.
In terms of what should be taken into account to prevent discrimination against individuals because of their age, disability status, or expected length of life; it is important to remember that:
o Eating disorders do not discriminate. Eating disorders affect up to 25 million Americans, from as young as age 8 through the lifespan. Without adequate access to effective, specialized care, many end up seeking disability coverage due to their illness.
In terms of what models HHS should consider in developing essential health benefits; there are some good model policies in effect currently:
o Insurance policies that include adequate and comprehensive access to specialized and comprehensive eating disorder care at all levels of treatment offer their members the opportunity for full recovery. Many insurers currently offer this type of coverage to their members. This type of treatment access is effective in successful treatment and resolution of the eating disorder. A fully recovered individual contributes to the workforce, is a productive and successful member of society.
In terms of what criteria should be used to update essential health benefits over time; we believe that the combination of research and clinical practice expertise yield the most comprehensive road-map for determining updates :
o As advances in eating disorders treatment are made, updates to essential health benefits should be related to clinical utility and integration of research findings.

Jeanine Cogan, Ph.D.
Policy Director
Eating Disorders Coalition

Wednesday, November 9, 2011

Over 200 Respond to HHS Action Alert! Thank You for Your Help

Dear EDC Advocates,

Before I began serving as the EDC's Policy Assistant I was an EDC Advocate who came to EDC National Lobby Days and participated in Action Alerts.

When I first became an EDC Advocate back in 2002, I admit, I did not firmly believe that my voice could make that much of a difference. I mean, every day I listened to NPR and watched CSPAN and heard endless stories of gridlock and spending cuts plaguing our Federal Government, so in the scheme of things I didn't think that one Kathleen MacDonald could make an impact. Today, I know better. I know that my voice matters. And I want you to know that your voice matters.

Last week the EDC invited you to raise your voice in a time-sensitive and highly important Action Alert. Over 200 of you wrote in to HHS, sharing your voice, your stories, your research, your knowledge, your loved one's memories and your specific requests regarding eating disorders and the soon to be determined Essential Health Benefits. You made an impact and you spoke for the countless millions who suffer, for the countless millions who try to access treatment only to be denied by their insurance company, for the countless whose lives have been cut far too short by these insidious diseases, and for future generations who can be prevented from suffering the most deadly of all mental illnesses.

On a personal note - with each one of your emails to HHS you increased the flame of hope within me. You increased my hope that together we will change the way those affected by eating disorders are treated --including families, sufferers, researchers, and clinicians.

Thank you for each of your comments to HHS and for your continued advocacy. We look forward to continuing our other advocacy efforts with you as we work to ensure that eating disorders research, treatment and education and prevention are adequately and duly addressed, and that people suffering from eating disorders receive the treatment, services and compassion they deserve.

Yours from the Hill, Kathleen

Photo courtesy