Guest Column: Insurance Companies Should Increase Mental Health Coverage

As the annual open enrollment period begins and Michiganders search for their best health insurance options for 2023, one major topic dominates health care discussions: mental health care.

According to the National Council for Mental Wellbeing, 1 in 5 adults (52.9 million) experienced a mental illness in the US in 2020, including 1 in 3 young adults aged 18-25. Suicide is the second leading cause of death among people aged 10-34.

In Michigan, a an estimated 1.3 million People have one type of mental health condition or the other.

lack of treatment

We are facing a growing mental health crisis in our country. More people are seeking treatment, but many are ineligible for free or reduced care, do not have the coverage they need or are unable to pay the high cost of care. Shockingly, 54% of adults with a mental illness are not receiving any treatment.

Much of the blame is due to insurance policies that are insufficient to cover mental health care.

While both public and private health care could be improved, private insurance plans often have weak coverage, low reimbursement rates for caregivers, and a very narrow set of mental health services. The result is that millions of our fellow Michiganders are not getting the comprehensive mental health care they need and deserve, and some don’t get treatment at all.

Residents living with anxiety and depression are often denied treatment, leading to disruption and serious, long-term effects on their work, lives and families, including bankruptcy.

Michigan residents support more affordable and accessible levels of mental health coverage: Research published this summer by Consumers for Quality Care showed that 89% of Michigan voters I believe that insurance should cover a wide range of mental health care and related prescriptions.

treat health equally

Mental health should be treated on the same basis as physical health care – but this is currently not the case.

For example, you may need an annual visit to your primary care physician, but the average course of treatment for outpatient psychotherapy is six sessions. Current parity laws, which set equal per-visit co-pays for mental health and physical health care, would result in a patient paying six times more in co-pays for a standard course of mental health care versus physical health care .

In addition, a range of standard and long-accepted, evidence-based services for mental health patients from respite care to home-based services, case management, crisis residential, drop-in centers, or assistance securing housing and employment may be required. , These are benefits that many Michiganders receive through public programs like Medicaid, yet remain absent from most private plans.

Even when coverage is provided, it is often a miracle to find a mental health care provider – a result of the very low reimbursement rates that insurance companies pay providers. Instead, people trying to access mental health care will often find that the mental health provider list is a “ghost network,” meaning that providers do not accept the patient’s insurance or have very long waiting lists.

Another factor is the huge increase in alcoholism and drug addiction in recent years. Coverage for these issues varies greatly, with key drugs often being excluded, making treatment difficult to access. Standard treatments that should always be an option are often unavailable, and people are often afraid to fight for their right to care because of the stigma of addiction.

Then, there’s a secret many people don’t even realize: Many mental health providers don’t even carry insurance and operate on a cash-only basis. Nearly half of the country’s psychiatrists are uninsured due to low reimbursement rates.

If you’re lucky enough to have one that will accept your insurance policy, they can be booked for months. So, if you are in urgent mental health need, you are on your own. This is an unsettling situation for people struggling with mental health and substance abuse challenges.

true parity

For Michigan residents looking for their next insurance policy during open enrollment, reading the fine print on mental health coverage can be an eye-opener. Companies offering these policies must commit to increasing transparency and making the necessary changes to achieve “real equality” for mental health. To get parity:

  • Co-pays for mental health care should be reduced
  • Network should be expanded to increase mental health providers accepting new patients
  • Require providers to increase reimbursement rates to see customers with insurance
  • Patients should be offered a full range of standard and long-accepted mental health services

If this is achieved, all Michigan residents will have access to the care they truly deserve, a fighting chance of recovery, and an opportunity to live a full and healthy life.

Robert Sheehan is the CEO of the Community Mental Health Association of Michigan.