FOR IMMEDIATE RELEASE, April 8, 2016
EX-WHITE HOUSE DRUG SPOKESMAN ROBERT WEINER & ANALYST ELIZABETH BURKE RIP INSURANCE COMPANIES FOR VIOLATING “PARITY” LAW AND DENYING TREATMENT—ARTICLE IN ALCOHOLISM AND DRUG ABUSE WEEKLY
“PARITY MEANS SAME COVERAGE OF DRUG AND MENTAL HEALTH ISSUES AS PHYSICAL ILLNESSES, WEINER AND BURKE NOTE, AND ALLEGE FEDERAL ENFORCEMENT IS MISSING
(Washington, DC)–Robert Weiner, former spokesman for the White House Office of National Drug Policy and the House Narcotics Committee, and policy analyst Elizabeth Burke are challenging the lack of enforcement of the mandated Parity laws intended to provide the same coverage of drug and mental health issues as physical illnesses, and are alleging discrimination.
Weiner and Burke argue in a newly published article in Alcoholism and Drug Abuse Weekly, one of the nation’s most respected sources for drug policy news, that in order to prevent health insurance discrimination, HHS and the Department of Justice must enforce the provisions of the Mental Health Parity and Addiction Equity Act and the Affordable Care Act. Despite the expanding heroin and opioid crisis, insurance companies are skirting around the MHPAEA, Weiner and Burke argue.
The article is entitled, “Parity was supposed to mean treatment — until insurance companies got in the way,” and appears in ADAW’s April 4 issue (see link to published article below).
Weiner and Burke wrote, “Despite the ongoing opioid crisis, insurance companies are skirting the Mental Health Parity and Addiction Equity Act (MHPAEA). Both the Affordable Care Act of 2010 (ACA) and the MHPAEA require insurance companies to provide parity for mental health and substance use disorders, but the insurance companies are coming up with every possible excuse not to do it. The law provides a strategy to take meaningful action — but the health insurance companies are, quite simply, blocking it.”
They argued, “Health care has been a constant issue in both the Republican and Democratic presidential debates. Chris Christie’s strongest moment of his failed presidential campaign was his speech, which went viral on social media, about his personal connection to constituents with drug addiction. It was a shining moment regardless of what party anyone supports. .Hillary Clinton proposed a $10 billion plan to provide substance use disorder treatment, as well as reversing the mass incarceration for nonviolent drug offenses that is overcrowding prisons. President Obama proposed a $1.1 billion plan toward treatment of prescription opioid abuse and heroin use.”
They pointed out, “Despite the existence of both the ACA and the MHPAEA, people still are not receiving the promised coverage. Private insurance exist by definition for profit. They maximize what people have to pay out of pocket, or remain untreated. The Nation Alliances on Mental Illness cited a 2014 National Survey on Drug Use and Health which found only ‘41% of adults in the U.S. with a mental health condition received mental health services in the past year.’ Insurance companies have identified the loopholes in the MHPAEA, and take advantage of their customers’ lack of knowledge about the requirements, and a willingness to accept the insurance evaluation as trustworthy.”
The authors wrote, “Under the MHPAEA, insurance companies are supposed to provide coverage for what is ‘medically necessary.’ This vague language allows insurance companies to be the decision-makers, rather than the actual doctor. In addition, insurance companies continue to deny coverage for their clients that clearly violate the MHPAEA. In one case, Chicago citizen Elizabeth A. Craft brought Health Care Service Corporation (HCSC, which includes Blue Cross and Blue Shield) to court for refusing to cover her 16-year-old daughter’s medical expenses in 2014. Although HCSC covered her daughter’s nine hospitalization visits caused by her post-traumatic stress disorder, major depressive disorder and anorexia nervosa, they denied the same coverage when they relocated her daughter to a residential treatment center.”
They asserted, “Insurance directly interfered with the treatment location that her physician recommended. The court forced HCSC to pay, because denying the location of treatment is a direct violation of parity laws.”
They explained, “Even covering simple medical treatment, such as prescription pills, is difficult. Insurance companies require ‘prior authorization’ for controlled substances. This is a form of discrimination.”
The two argue, “Insurance companies do not understand the immediacy and necessity in treating mental health and addiction.”
They continued, “Even with the confusion and lack of effective implementation of the Mental Health Parity and Addiction Equity Act, there is a solution, to strengthen the Affordable Care Act. But as Hillary Clinton has said, revisiting the law could create a horrific congressional debate that could jeopardize health care reform completely. A far easier approach would be for the Department of Health and Human Services to enforce and implement new and existing regulations that mandate the insurance companies, who make enormous profits, to do their jobs.”
They wrote, “Health insurance profits have soared with the 20 million new enrollees and the private-insurance structure compromise Obamacare employed versus the single payer and government option Congress rejected. Since March 2010, each of the six largest health insurance companies — United, Health Net, Anthem, Aetna, Cigna and Humana — have increased profits by 224 percent to 375 percent.”
They concluded, “Instead of allowing insurance companies to force consumers to .restrict their care, we need to tighten up the federal regulations and enforcement of the two laws. Insurance coverage is possible. If we enforce the ACA as the law provides, more people can receive their basic right to health insurance including drug treatment. The federal government needs to take a tip from states with the strongest parity laws.”
Robert Weiner is a former spokesman for the White House Office of National Drug Policy and the House Narcotics Committee. Elizabeth Burke is health policy analyst at Robert Weiner Associates and Solutions for Change.
Other published op-eds by Robert Weiner: http://www.weinerpublic.com/opeds.html