Talkin' about a revolution...in mental health parity...well, sort of

In New Jersey, a revolution in mental health parity is taking place. But it's almost a revolution by default.

The General Assembly in Trenton is supposed to post a mental health parity bill in the lame duck session this year that could finally bring about long-needed equalization of insurance benefits.

But the road to get here has been long and rocky. And unnecessary, really.

And mental health advocates don't understand why Trenton politicians fail to sense the growing public desire to do something to help people who suffer from postpartum depression, schizophrenia and other disorders.

People see the impact of these disorders on city streets. Many people who can't afford to get treatment self-medicate by using illegal drugs and alcohol. Their addictions cost them their lives, their families and their homes. Many end up homeless, or in jail.

"Equalization of insurance health benefits to properly cover mental disorders including substance use disorders is right and just," said Joseph Napoli, immediate past president of the New Jersey Psychiatric Association. "It is also cost-effective. The present inadequate coverage for these disorders is penny-wise and dollar-foolish."

Napoli is cautiously optimistic that the legislature will finally act. But mental health parity is not a new idea in New Jersey. And every time it's been given a chance to work, something gets in the way that defeats it - or weakens it.

In 1999, for example, New Jersey passed a parity law, but in a final compromise, the required health benefit coverage was limited to "biologically-based" mental disorders and excluded substance use disorders.

This has created a loop hole that insurance companies have used to deny coverage, says Napoli.

He noted that Aetna and Horizon inadequately cover care for New Jersey residents who suffer from anorexia nervosa because these insurance companies have decreed - contrary to scientific evidence - that anorexia nervosa is not "biologically-based."

Although the present law lists eight "biologically-based" mental disorders, anorexia nervosa is not among them.

"We can easily count the numerous ways that we all pay dearly because insurance companies refuse to cover these disorders at the same amounts and limits that apply to other disorders," Napoli said. "Insurance companies' costs are greater for general medical conditions complicated by mental disorders."

Hope re-emerged in 2002, when N.J. Sens. John Matheussen and Joseph Vitale sponsored a parity bill that would eliminate the loop hole. Assemblywomen Loretta Weinberg and Mary Previte sponsored a companion bill. Unfortunately, Napoli noted, the state budget crisis torpedoed these bills.

In 2006 Sens. Vitale and Barbara Buono and Assemblyman Robert Gordon, among others, re-introduced the parity bills. In December, the New Jersey Senate passed S807 with a vote of 29 to 9 - despite Governor Corzine's opposition.

In May, the Assembly Appropriations Committee voted the bill out of committee. Five months later, the bill is pending in the General Assembly

Napoli is hopeful that some action can finally be taken. So-called shrewd lawmakers, however, pushed any consideration of it until after the fall elections. Apparently, legislators must believe that support of this legislation could be used against them in an election campaign.

And support is not a guarantee, given Corzine's prior opposition to parity legislation.

Right: Dick Codey

But New Jersey is home to Senate President Dick Codey, the former acting governor who became a national symbol for championing mental health causes on a political level and bringing more money and attention to mental health programs.

Oh, and by the way, he also happens to have the highest approval ratings of any public official in this state.

To Napoli, the whole thing is dumbfounding.

"How can we allow this discrimination against individuals suffering with mental disorders, including substance use disorders?" Napoli said. "We need parity now."