TRENTON – A bill sponsored by Senators Joseph F. Vitale and Barbara Buono which would require health insurers in New Jersey to cover treatment for alcoholism and substance abuse disorders under the same terms and conditions used for other diseases and illnesses was approved by the Senate Health, Human Services and Senior Citizens Committee today by a vote of 6-0, with four abstentions.
“Right now in the Garden State, your health insurance safety net isn’t as complete as you’d like to think,” said Senator Vitale, D-Middlesex, the Chair of the Senate Health Committee. “While medical professionals universally consider mental disorders, alcoholism and substance abuse as illnesses, insurers seem to classify these diseases in another realm entirely, and deny coverage to costly, yet effective treatment. There needs to be a measure of parity and equity in how insurers treat medically-identified diseases, to give all New Jersey health consumers access to the treatment they need.”
“Under current insurance regulations, apparently all diseases aren’t created equal,” said Senator Buono, D-Middlesex. “Medically necessary treatment for certain mental health disorders and substance abuse are routinely denied because they aren’t classified under the same regulatory definitions as other diseases. We need to step in, and ensure that all New Jerseyans can have the treatment they need, whatever the disease.”
The bill, S-607, would expand mandated health insurance coverage for treatment of mental and nervous disorders and alcoholism and substance abuse disorders. The bill would apply to all health insurers in New Jersey, including the State Health Benefits Plan.
Under the provisions of the bill, all mental and nervous disorders currently contained in the latest editions of the Diagnostic and Statistical Manual of Mental Disorders – the principal diagnostic reference used by mental health professionals in the United States – would be covered. Under current law, only biologically-based mental disorders are required to be covered by insurers. Coverage for alcoholism and substance abuse disorders would be provided based on a medical diagnosis, and treatment would be based on a prescription from a licensed health care provider, and would include inpatient and outpatient care, detoxification and family, group or individual counseling.
“Medically-identified diseases need to be treated under appropriate health care guidelines, but for New Jerseyans suffering from certain mental health disorders, the cost of treatment makes it impossible for them to recover,” said Senator Buono. “This to me seems to be the very reason why we have health insurance in the first place – to offset the high cost of individual health care and provide access to necessary treatment. We need to revise existing insurance guidelines, to provide equity and access to treatment for all those in need.”
“It is unfair to, on one hand, say someone’s suffering from a disease, but on the other deny insurance coverage for treatment of the disease,” said Senator Vitale. “Addiction disorders, alcoholism, and nervous disorders are universally recognized as medically-based diseases, and insurance companies need to treat them as such. This bill introduces some much-needed fairness in how insurance providers cover mental health disorders of all shapes and sizes.”
The bill now heads to the Senate Budget and Appropriations Committee before going to the full Senate for consideration.