Nine in 10 Texans think it's harder to talk about a mental health condition than a physical health issue. The one place where it’s easier to talk about mental rather than physical health seems to be in the Texas Legislature, where a handful of bills are speeding through the House with near unanimous support. Among them is a bill to help enforce coverage of mental health benefits.
Getting mental health care coverage
Here’s the idea behind what’s called parity for mental health coverage: If your health insurance covers cancer treatment, it should also cover treatment for depression or addiction.
“Enforcing mental health coverage on par or in parity with physical health coverage is not a new idea,” says Texas State Rep. Four Price of Amarillo. “However, it’s really the enforcement of it is where some gaps in coverage has existed.”
Price, a Republican, is chairman of the House Public Health Committee. After being appointed by Texas House Speaker Joe Straus, he spent months researching weaknesses in the state’s mental health system. The conclusion? People across the state have coverage for mental health care but aren’t getting it. State and federal parity laws, which were expanded under the Affordable Care Act, make it illegal to handle mental health differently than physical health. For example, if a copay for a doctor's visit is $20, a psychiatrist visit shouldn’t be $40.
Dr. Andy Keller, CEO of the Meadows Mental Health Policy Institute in Dallas says lots of people don’t know they're entitled to mental health benefits. That’s despite the fact that three in four Texans have a friend or family member who’s experienced a mental health issue.
“Either they have a mental health condition, their loved one does, family member does, someone important to them, exact same percentage as cancer,” Keller says.
Like cancer, conditions such as depression and anxiety, even psychosis are treatable. But, Keller says, the longer the delay for therapy or medication the tricker and more expensive treatment becomes.
“Maybe one in 10 of those folks get access to that kind of care,” Keller says. He spoke to community members about the situation in North Texas at the Dallas Festival of Ideas in April.
Helping Texans know their rights
Instead of it becoming easier to access mental health care over the past decade, it’s become more difficult. That’s what a new, major national study in the journal Psychiatric Services reveals. The lead investigator is Dr. Judith Weissman, an epidemiologist at NYU's Langone Medical Center. She says one in 10 distressed Americans in 2014 still did not have health insurance that would cover seeing a psychiatrist. That’s a slight rise from 2006. Also up? Treatment delays.
“In other words, there’s actually a greater proportion of adults who lack access to care and insufficient money to purchase necessary medications for their health care than there were prior the recession of 2008.”
So what’s missing? In part, Texas legislator Price says, enforcement of existing laws and a place for Texans to bring their complaints. That’s why he authored HB 10, which is now in the Senate. The bill would create an ombudsman to help consumers navigate the insurance market and follow up when coverage is wrongly denied.
Price, who has authored a handful of other mental health bills says it’s been refreshing to work on an issue with such bipartisan support. In the minefield that is health care, mental health may be the one thing just about everyone can agree on.