EDC Survey of Benchmark Plans

See the full document here.

Beginning on January 1 2014, the Affordable Care Act (ACA) requires that all (non-grandfathered) individual and small group health insurance plans sold in a state cover certain essential health benefits (EHB’s). In January 2013, the Eating Disorders Coalition (EDC) surveyed all of fifty states and the District of Columbia’s proposed benchmark plans and discovered a wide disparity in the anticipated mental health service coverage between states. 

Executive Summary

There exists a 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 troubling disparity is of great concern for people struggling with eating disorders and other mental health and substance abuse issues across the country.

According to our survey, twenty-seven of the benchmark plans severely limit mental health services. Seventeen of these plans have day limits on mental health services and nine states have exclusions for residential services. In some cases, the states with limits on mental health do not have the same limits on substance abuse services; in other cases limits are extreme for both mental health and substance abuse. Given that similar limits are not seen in medical services, the disparity on quantitative day limits and unequal exclusionary status should not be allowed under Mental Health Parity.

In contrast, our review indicates that twenty-four states have strong mental health coverage, without non-equitable service limits. Vermont has the strongest coverage for eating disorders and Connecticut, Idaho, and Maine also having very strong plans.  

With half 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 half of the nation to provide for inclusive coverage of these illnesses. As the benchmark plans are implemented, it is imperative that states offer equitable and adequate access to care for people suffering with mental health conditions, including eating disorders. It is also imperative that all Benchmark plans follow Mental Health Parity.  We urge advocates to monitor and influence the implementation in their states, specifics for each state can be found at http://healthreform.kff.org/state-exchange-profiles-page.aspx.

Download the entire document here.

A New Eating Disorders RFA!!!

As you may remember last summer the EDC worked to ensure that the Senate Appropriations Committee agreed to FY 2013 funding for federally financed health research. The Bill contained a congressional directive "urging the National Institute of Health (NIH) to expand, intensify, and coordinate its research on eating disorders and to examine the possibility of creating collaborative consortia on eating disorders research".   Yesterday, we saw the first result of that language, a Request for Application (RFA) was released by NIH. See here for the text of the RFA.

Join Us for Lobby Day!

Registration is now open for our Spring Lobby Day, April 17 in Washington, DC. The registration and all relevant info is available here. See you in April!  

Melanie Morris Joins EDC Team!

It's National Eating Disorders Awareness week, and we're recognizing this by expanding our team!

 

FOR IMMEDIATE RELEASE

Contact: Melanie Morris

(202) 543-9570

February 27, 2013

The Eating Disorder Coalition Hires Melanie Morris

as Communications and Policy Consultant

The Eating Disorder Coalition, the federal advocacy organization for eating disorders, is pleased to welcome Melanie J. Morris as Communications and Policy Consultant. Ms. Morris brings nearly a decade of health policy experience having previously served as Senior Director at Simon & Co., a boutique health policy firm, and as Director at Jefferson Consulting Group a government relations and federal business development firm.

Jeanine Cogan, Policy Director said, “We are very excited that Ms. Morris is joining our team at this critical point in the implementation of the Affordable Care Act. Her expertise is an asset as we continue work with Congress and federal agencies to ensure that people with eating disorders receive the care they need.”

The Eating Disorder Coalition is a non-profit policy and advocacy organization for persons with eating disorders located in Washington, DC. For more information, visit www.eatingdisorderscoalition.org.

 

Just released today! An issue brief from the Office of Assistant Secretary for Planning and Evaluation (ASPE)

ASPE ISSUE BRIEF

Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans

February 20, 2013

By: Kirsten Beronio, Rosa Po, Laura Skopec, Sherry Glied

Abstract

The Affordable Care Act builds on the Mental Health Parity and Addiction Equity Act of 2008 to extend federal parity protections to 62 million Americans. The parity law aims to ensure that when coverage for mental health and substance use conditions is provided, it is generally comparable to coverage for medical and surgical care. The Affordable Care Act builds on the parity law by requiring coverage of mental health and substance use disorder benefits for millions of Americans in the individual and small group markets who currently lack these benefits, and expanding parity requirements to apply to millions of Americans whose coverage did not previously comply with those requirements.

Read full report: http://aspe.hhs.gov/health/reports/2013/mental/rb_mental.cfm

Senator Harkin holds hearing on mental health after the Newtown shootings on Capitol Hill.

This is an important moment in history where the nation focuses on the important of addressing mental health through smart and prudent policies.

The EDC is particularly grateful for Senator Patty Murray's strong insistence that the final rule for mental health parity needs to be released no later than April this year!

Here are a few quotes we thought was worth highlighting:
"It is important we don't stigmatize mental health." Senator Franken

"Only 1 in 5 children with mental health issues get treated." Senator Franken

"It is absolutely vital that we detect earlier and intervene earlier with something we know is effective." Tom Insel, Director of NIMH

"You can't have mental health without mental health practitioners. . . I went into graduate school on an NIH grant when this 1963 bill was signed for mental health community centers . . . because of that I was able to go to graduate school and get a master's degree in social work . . . the consequences of well trained people and what they then produce in our society I know is important. Senator Mikulski

"I would agree that we need more practitioners." Pamela Hyde, Administrator, SAMHSA

"We have to make sure that mental health is available to all people regardless of their income all over this country." Senator Sanders

To read the testimony of witnesses see the below pdf files. You can also view the video at http://www.help.senate.gov/hearings/hearing/?id=b2048a10-5056-a032-529c-340d7ae5f237

Witnesses

Panel I

• Ms. Pamela Hyde, Administrator, Substance Abuse and Mental Health Services Administration, Rockville, MD
Download File

• Dr. Thomas Insel, Director, National Institute of Mental Health at the National Institutes of Health, Bethesda, MD
Download File

Panel II

• Michael Hogan Ph.D., Former Commissioner, New York State Office of Mental Health, and Chairman, President’s New Freedom Commission on Mental Health, Delmar, NY
Download File

• Robert Vero, Ed.D., Chief Executive Officer, Centerstone of Tennessee, Nashville, TN
Download File

• George DelGrosso, M.A., Executive Director, Colorado Behavioral Health Council, Denver, CO
Download File

• Larry Fricks, Senior Consultant, National Council for Behavioral Health, Cleveland, GA
Download File

EDC applauds the President for addressing mental health through his commitment to finalizing the parity regulations and attention to essential health benefits.

Obama gun plan calls for long-awaited rules on mental health
By Sam Baker - 01/16/13 12:31 PM ET
From Healthwatch - The Hill's Healthcare Blog

President Obama's plan to reduce gun violence calls for long-awaited rules requiring insurance companies to cover mental health services.

Obama said his administration would finalize rules on mental health parity, the requiring of mental healthcare to be covered the same way as physical healthcare. The regulations have languished since 2008, and Senate Democrats had called on Obama to push the rules forward as part of his gun-control recommendations.

Obama also said his administration would be "issuing guidance making clear that the Affordable Care Act does not prevent doctors from talking to patients about gun safety," amid a host of other healthcare-related actions and recommendations.

The White House plan calls for bolstering access to mental health services in schools and encouraging teachers to intervene early when they believe a student needs counseling.

Obama also directed the Centers for Disease Control and Prevention to study gun violence, despite a congressional order that prohibits the agency from conducting any research that would "advocate or promote gun control."

Obama said that order should not be read as an all-out ban on gun research, and he called on Congress to provide $10 million in funding for the CDC to study gun violence and possible links to violent movies and video games.

THE WHITE HOUSE

Office of the Press Secretary

EMBARGOED UNTIL THE START OF THE PRESIDENT’S REMARKS

January 16, 2013

Gun Violence Reduction Executive Actions
Today, the President is announcing that he and the Administration will:

1. Issue a Presidential Memorandum to require federal agencies to make relevant data available to the federal background check system.
2. Address unnecessary legal barriers, particularly relating to the Health Insurance Portability and Accountability Act, that may prevent states from making information available to the background check system.
3. Improve incentives for states to share information with the background check system.
4. Direct the Attorney General to review categories of individuals prohibited from having a gun to make sure dangerous people are not slipping through the cracks.
5. Propose rulemaking to give law enforcement the ability to run a full background check on an individual before returning a seized gun.
6. Publish a letter from ATF to federally licensed gun dealers providing guidance on how to run background checks for private sellers.
7. Launch a national safe and responsible gun ownership campaign.
8. Review safety standards for gun locks and gun safes (Consumer Product Safety Commission).
9. Issue a Presidential Memorandum to require federal law enforcement to trace guns recovered in criminal investigations.
10. Release a DOJ report analyzing information on lost and stolen guns and make it widely available to law enforcement.
11. Nominate an ATF director.
12. Provide law enforcement, first responders, and school officials with proper training for active shooter situations.
13. Maximize enforcement efforts to prevent gun violence and prosecute gun crime.
14. Issue a Presidential Memorandum directing the Centers for Disease Control to research the causes and prevention of gun violence.
15. Direct the Attorney General to issue a report on the availability and most effective use of new gun safety technologies and challenge the private sector to develop innovative technologies.
16. Clarify that the Affordable Care Act does not prohibit doctors asking their patients about guns in their homes.
17. Release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities.
18. Provide incentives for schools to hire school resource officers.
19. Develop model emergency response plans for schools, houses of worship and institutions of higher education.
20. Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover.
21. Finalize regulations clarifying essential health benefits and parity requirements within ACA exchanges.
22. Commit to finalizing mental health parity regulations.
23. Launch a national dialogue led by Secretaries Sebelius and Duncan on mental health.