Warren makes point on disparities in insurance coverage for physical and mental health

[bluewater]

Warren makes point on disparities in insurance coverage for physical and mental health

During a July visit to Milwaukee, Democratic presidential hopeful Elizabeth Warren told an audience that when it comes to their mental health needs, their health insurer may not always be on their side.

According to the Massachusetts senator, that’s because there is an unequal playing field when it comes to coverage of physical and mental health needs.

"The law says that mental health must be treated the same as physical health," Warren said at the League of United Latin American Citizens convention in Milwaukee on July 11, 2019, referencing the idea that health providers don’t care equally for the two.

Warren was among eight Democratic presidential contenders, plus Jill Biden, wife of candidate Joe Biden, who attended the convention. LULAC is the largest and oldest Hispanic civil rights organization in the country.

But what does the law say about physical vs. mental health?

And, as Warren contends, do insurers treat them unequally?
[snip]

Our ruling

Warren claimed mental health and physical health have to be treated the same under the law, but coverage by health insurers is unequal.

The Mental Health Parity and Addiction Equity Act says insurers must provide equal coverage of physical and mental health. The ACA made it a requirement for insurers to cover certain benefits which included behavioral health.

But various studies and reports found that insurers often fall short of upholding this law.

We rate this claim True.

https://www.politifact.com/wisconsin/statements/2019/aug/20/elizabeth-warren/warren-makes-point-disparities-insurance-coverage-/

[spooky3]

1. One big difference the article doesn't mention

At least in my metro area, according to a counselor I know, in-network reimbursement rates aren’t high enough even to cover her office expenses and malpractice premiums, let alone pay her salary. So, very few good, experienced providers agree to be in-network.

As a result, insurance may end up paying only about half of the cost of counselors, with the client paying the rest. So many simply can’t afford it and don’t get needed help.


Unlike GPs, counselors have to give their clients their full attention for the 45 minute or so sessions, then do paperwork. GPs can delegate a lot of work to lower paid receptionists, billing people, nurse practitioners and physician assistants. So counselors really can’t cut expenses much.

[matt819]

3. While we're on the subject of what's covered and what's not

How did dental health fall through the cracks? Did someone confuse dental and mental?

Re mental - I get three visits a year with a $40 copay. Anything more, out of pocket. Good thing I'm only moderately crazy and not full-on crazy (though there are days. . . ).

Dental? Fuhgetaboutit.

PCIntern probably has chapter and verse on this.