Wednesday, January 9, 2013

New EDC survey of the Essential Health Benefits finds wide disparity in anticipated mental health service coverage between states.

The Eating Disorders Coalition survey of benchmark plans from all 50 states plus District of Columbia shows wide disparity in anticipated mental health and substance abuse service coverage between states, particularly as it relates to residential care and eating disorder care. This disparity is of great concern for people struggling with eating disorders and other mental health and substance abuse issues across the country.

By our review, 27 of the benchmark plans severely limit mental health services, with 9 specifically excluding residential care and a few exclusively limited eating disorder residential treatment. Many of these plans have day limits on mental health services and exclusions for residential services included in a list of completely unrelated items that are typically not included. In many cases, the states with limits on mental health do not have the same limits on Substance Abuse services; in some cases limits are extreme for both mental health and substance abuse.

Given that similar limits are not seen in medical services, it seems that this disparity, both on quantitative day limits and unequal exclusionary status should not be allowed under Mental Health Parity.

In contrast, our review indicates that 24 states have strong mental health coverage, without non-equitable service limits. Many specifically include residential treatment, a few highlight eating disorder treatment inclusion. The states of Maine and Vermont seem to have the strongest coverage for eating disorders, while numerous other states have strong coverage with no stated day limits and no exclusion for residential care.

With ½ of the states including equitable coverage for mental health and substance abuse services, there is strong evidence that plans can and do include equitable and inclusive treatment for mental health and substance abuse. There is a pressing need for the other ½ of the nation to provide for inclusive coverage of these illnesses.

As the nation moves forward with implementing the ACA state by state, it is imperative that attention be paid to equitable and adequate access to care for people suffering with mental health conditions, including eating disorders.

Source for the plans:

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