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03.11.10

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Nominations now being accepted for the 2010 America Honors Recovery Awards! Learn more...

 

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is a statement of the principle that all Americans have a right to recover from addiction to alcohol and other drugs. Learn more…

 

Campaigns: Addiction Recovery Insurance Equity

Interim Regulations announced for the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008

On October 3, President Bush signed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 into law as part of the Emergency Economic Stabilization Act (HR 1424). The law will begin to end the insurance discrimination facing people with addiction and mental illness. Learn more...

Recent updates

January, 2010: The Advocates for Human Potential recently released their white paper on the Mental Health Parity and Addiction Equity Act interim regulations. The paper, which includes the Legal Action Center's preliminary analysis of the regulations, reviews the operational and strategic implications of the regulations for plans, payers and providers. The paper discusses the challenges and unanswered questions that remain as the MHPAEA is implemented, and identifies opportunities that are available to stakeholders in the field. Learn more...

January 29, 2010: The US Departments of Health and Human Services, Treasury and Labor have released interim regulations providing guidance on how the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act must be implemented.

Faces & Voices belongs to the Parity Implementation Coalition and will be working with allied organizations to provide comments on the regulations. Public comments will be accepted through May 3, 2010.  Instructions for how to comment are included in the official notice, to be published in the Federal Register on Tues, Feb. 2. We are collecting stories of people who have been denied coverage since the law went into effect. Please use this form to document any denial of coverage that you or others have experienced.

The interim regulations go into effect on April 5, 2010 and apply to group insurance plans with plan years starting on July 1, 2010 or later. The interim regulations apply to group insurance plans of 50 or more people. Although the Wellstone-Domenici law also applies to Medicaid managed care plans, these plans are not included in the interim regulations.

January 4, 2010: Most of us start off the new year with a commitment to change or want to fix some troubling aspect of our lives. For millions of Americans who wake up with a hangover on Jan. 1 and vow to quit drinking or taking drugs, their resolve this year comes with an unprecedented resource: their own health insurance.

Named for the former U.S. senators who championed the legislation in Congress, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Parity Act eliminate discrimination by insurance companies by expanding access to treatment for people who want to use their coverage to get help for addiction to alcohol or other drugs, as well as depression, eating disorders and other mental illnesses. Learn More...

November-December 2008: Parity: What Does The New Law Mean?

November 17, 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Celebration powerpoint

September 10, 2008: Sign-on letter to Members of Congress asking for action on insurance discrimination in September 2008. Learn more...

September 24, 2008: On Tuesday, the US House and US Senate voted on the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act...learn more

September 17, 2008: Join us on September 17 at 9:30 am for a rally on Capitol Hill...learn more

September 10, 2008: Thanks to everyone who called in on September 10th! Learn more...

August 11, 2008: Meet with your member of Congress over recess and ask them to end insurance discrimination! Learn more...

July 30, 2008: The US Senate failed to pass a bill that included the compromise bill that has been negotiated by the House and Senate by a vote of 51 to 43. To see how your Senator voted click here. Former First Ladies Betty Ford and Rosalyn Carter wrote to Senate leaders supporting passage of the bill.

July 1, 2008: Although House and Senate leaders have not decided yet where they will find nearly $4 billion over 10 years to pay for the cost offsets required by Congressional rules, negotiations have successfully concluded on the key policy provisions.  This compromise is the result of long negotiations and advocacy of organizations all across the country. The compromise includes many key provisions that were included in the House-passed bill, the Paul Wellstone Mental Health and Addiction Equity Act and would be an important step in ending insurance discrimination facing people with addiction and mental illness. Here are some key points in the compromise:

  • The compromise requires parity in insurance coverage for addiction and mental health treatment for both in-network and out-of-network coverage.  This does not mean that the bill requires that insurers cover addiction and mental services, only that if they do cover these services, there must be parity with medical/surgical benefits.  This of course would be a very positive development both in requiring fairness in insurance coverage and taking a strong stand against discrimination toward people in recovery or still suffering from addiction and mental illness.

  • The compromise requires plans to disclose their medical necessity criteria and reasons for any denials of coverage.  This would be a major breakthrough, as many plans refuse to disclose medical necessity criteria or reasons for denial, especially when addiction treatment is sought. 

  • On the issue of protection of state laws, the compromise bill language is silent.  The House bill explicitly protected state laws, and in earlier versions the Senate bill explicitly preempted state laws.  Silence is a victory for those of us who agree with the House approach that state laws should be protected, since in most situations Congress must take explicit action to overrule a state law in order for state laws to be preempted.  However, to make protection of state laws even more ironclad, we will be working to ensure that the legislative history of the bill makes clear that the sponsors’ intention is to protect all state laws.  That way, as important as the passage of a federal parity law would be, stronger state laws would remain in effect and states would be free to enact additional stronger protections in the years to come.

March 6, 2008: The U.S. House of Representatives passed the Paul Wellstone Mental Health and Addiction Equity Act by a bipartisan vote of 268-148. The Senate passed its version of the bill, the Mental Health Parity Act of 2007, by unanimous consent in September 2007 (click here to see a comparison of the two bills). The two houses of Congress will now need to meet and reach a compromise on parity if the legislation is to move swiftly toward a vote in a legislative calendar shortened by the presidential election season. We will keep you updated about future advocacy opportunities to help end insurance discrimination.

US House passes Paul Wellstone Mental Health and Addiction Equity Act!


(Representatives Jim Ramstad, Patrick Kennedy, Nancy Pelosi, Steny Hoyer, former First Lady Rossalyn Carter and David Wellstone rally for passage of the Wellstone bill in front of the U.S. Capitol Building)

Press coverage

Check out recently published Letters to the Editor and Editorials from recovery advocates around the country!

Check out recent news coverage from around the country!

What is Insurance Discrimination?

Most health plans continue to impose limits on how much treatment is covered or more costly financial requirements on mental health and addiction care than on care for other health conditions, discriminating against people seeking help for addiction.

Equal coverage for drug and alcohol treatment and recovery support services would require health insurers to provide coverage at the same level as for other chronic, relapsing disorders such as diabetes and hypertension. Discriminatory policies require individuals and their family members to pay higher deductibles and co-payments and receive less coverage for number of visits, days of coverage, and annual or lifetime dollar limits for treatment.

Four states have comprehensive parity for addiction for all citizens – Connecticut, Maryland, Minnesota, and Vermont. Seven other states require some lesser level of coverage. The Alcohol Policy Information System lists the different coverage offered for each state.

All Federal employees have parity under the Federal Employee Health Benefit Plan, the largest employer-sponsored health program in the country, covering 9 million federal employees, their families, and retirees.

Recent studies have shown that the economic benefits of treating people with addiction outweigh the costs. Researchers found that the benefits outweighed the costs seven-fold, because of increased job earnings and reduced costs related to crime and imprisonment. They also found reduced costs for emergency room visits, outpatient care and residential care.

Greater public attention and understanding

Representatives Kennedy and Ramstad, co-chairs of the Congressional Caucus on Addiction Treatment and Recovery have been holding field hearings across the country (Read testimony from the New Jersey Field Hearing on February 26th and testimony from Deirdre Drohan Forbes and Thom Forbes from the New York Field Hearing on March 16th) with allied members of Congress to bring the stories of the toll of insurance discrimination and the hope of recovery to their communities and the media. The well-attended hearings have received great coverage in the media and mobilized advocates for insurance equity.

New calls for insurance reform

For years Representatives Ramstad and Kennedy have fought for equal treatment of mental illnesses and addiction in health care. Bipartisan majorities in the US House of Representatives have supported their efforts to enact the Paul Wellstone Mental Health and Addiction Equity Act since 2002. Unfortunately they were never able to bring the bill to the floor of the House for a vote because they were blocked by the Republican House leadership.

The chances of passing meaningful insurance reform are improving:

  • A 2006 Institute of Medicine report called for laws requiring insurers to offer the coverage that is needed for high quality, comprehensive health coverage for addiction.
  • The use of addiction treatment paid for with employer-based health insurance has declined significantly over recent years – taxpayers are footing the bill for over 75 percent of treatment today. From 1992 to 2001, the percentage of people who used employer-based health coverage to pay for treatment dropped 23 percent.
  • HBO’s show ADDICTION, set to air March 15, 2007, will show the impact of unfair insurance laws on families who have lost their children to addiction.

Faces & Voices of Recovery and the fight for insurance equity

Faces & Voices of Recovery believes that everyone has a right to be free from addiction, regardless of the particular path taken. We know that recovery from addiction to alcohol and other drugs is real for millions of Americans and tens of thousands more get well every year. That’s why our Right to Addiction Recovery platform calls for “a healthcare system that fully addresses the medical needs of people with addiction to alcohol and other drugs and provides a recovery continuum of care,” calling for public and private insurance that provides access to coverage equivalent to other medical conditions.

Talking about insurance discrimination

Most Americans have no idea about the discrimination that people with addiction and their families face when they’re trying to get help. That’s why we need to let our friends, neighbors and opinion leaders know:

  1. What insurance discrimination is and means
  2. What insurance equity will mean

Here are some ways to talk about this critical issue with your friends and neighbors:

  • Insurance discrimination denies people with addiction the same insurance protection as people with other health issues.
  • As a result of this discrimination, many are unable to get the treatment and recovery support services necessary to achieve long-term recovery.
  • We must ensure that appropriate recovery support services and treatments are available to those who need them.
  • It is crucial, therefore, that we stop insurance discrimination, which denies people with addiction from getting the same protection as people with other health issues.
  • I am living proof that people can recover from addiction and make a better life for themselves and their families, but I would not have been able to do it without help and support.
  • Unfortunately, many people are not so lucky. Many are denied access to services because their insurance companies will not pay for it or are not required to cover it.
  • Insurance discrimination for those who need help to recover from addiction needs to end and that is what we are fighting to do.

We will be sending out more information about the proposals for insurance equity and opportunities for you to weigh in to support an end to addiction recovery insurance discrimination!

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