Act aims to close mental health coverage gap 

Mental health and alcohol treatment costs for Suzanne Aubry’s daughter have drained her family’s nest egg, costing them thousands of dollars in out-of-pocket expenses each year due to limits placed on their insurance coverage.

The price began to soar shortly after one of her four daughters, Jenny, then 14, began to suffer from paranoia and suicidal depression in 1999, said Aubry, who now works as a family liaison in the San Mateo County Office of Consumer and Family Affairs for mental health. And while a portion of the costs to treat Jenny’s ongoing mental illness is covered by the family’s insurer, there is no coverage for her alcohol addiction, which Jenny developed later after becoming depressed, Aubry told a panel of congressional lawmakers Wednesday during a field hearing on mental health and addiction equity held at the county Hall of Justice.

Like the Aubrys, thousands of families across the country are limited by how much their insurance carriers will pay when it comes to treating mental illness and addiction, said U.S. Rep. Jim Ramstad, R-Minn., sponsor of a new bill, dubbed the Paul Wellstone Mental Health and Addiction Equity Act. Nearly 90 percent of insurance plans impose financial limitations and treatment restrictions on mental health and addiction care, according to the U.S. Government Accountability Office.

One in five families are touched by mental illness at some point in their lives, with one in 17 people affected, according to the National Alliance on Mental Illness.

Ramstad, along with co-sponsor Rep. Patrick Kennedy, D-R.I., spoke and listened to local health professionals and families at hearings chaired by Rep. Anna Eshoo, D-Palo Alto.

The act, now making its way through Congress, would amend existing law to prevent insurance plans with 50 or more people from charging higher premiums and co-pays for mental illness and addiction treatments, Kennedy said.

The American Insurance Association, which represents the insurance industry, couldn’t be reached after-hours for comment Wednesday.

"Americans with these physiological diseases of the brain pay their premiums like everyone else and their insurance should be there when they need it, like it is for everyone else," Kennedy said.

Combined, untreated mental illness and addiction costs government and business an estimate $1 trillion a year nationwide, according to Rep. Ramstad’s office.

Many plans limit treatment to 45- or 90-day in-patient treatment, creating large gaps in coverage, said Alison Mills, a member of San Mateo County’s Mental Health Board.

Aside from parity in costs, many plans only cover those classified with "serious" mental illness, leaving out any hope of arresting mental illness early, said Gale Battaille, mental health director for San Mateo County.

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